LANCE EDWARD ENGDAHL Optometrist License verification

Business Entity

INACTIVE

License Type

Optometrist

Description

LICENSED OPTOMETRIST

License Number

046011158

License Status

INACTIVE

Business

First Name

LANCE

Middle

EDWARD

Last Name

ENGDAHL

Business Name

LANCE EDWARD ENGDAHL

Original Issue Date

01/11/2018

Effective Date

01/04/2020

Expiration Date

05/31/2022

City

MADISON

State

Zip

53718

County

WISCONSIN

Ever Disciplined

LastModifiedDate

03/10/2022