ANDRIENA FAY ERICKSON OD Optometrist License verification

Business Entity

INACTIVE

License Type

Optometrist

Description

LICENSED OPTOMETRIST

License Number

046009470

License Status

INACTIVE

Business

First Name

ANDRIENA

Middle

FAY

Last Name

ERICKSON

Suffix

Business Name

ANDRIENA FAY ERICKSON OD

Original Issue Date

06/27/2002

Effective Date

04/13/2004

Expiration Date

03/31/2004

City

DAYTON

State

Zip

45419

County

OHIO

Ever Disciplined

LastModifiedDate

09/11/2005