JACK R LARSEN Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST

License Number

046005216

License Status

NOT RENEWED

Business

First Name

JACK R

Last Name

LARSEN

Business Name

JACK R LARSEN

Expiration Date

01/01/1997

City

AMERY

State

Zip

54001

County

WISCONSIN

Ever Disciplined

LastModifiedDate

08/31/2005