The holder whose full name is Johnson, Ansel Titus,come from BLUE ISLAND IL,hold the Optometric Legend Drug Certificate license(NO.18002452B) which status is Expired.
| Name | Johnson, Ansel Titus |
|---|---|
| License Number | 18002452B |
| License Type | Optometric Legend Drug Certificate |
| License Status | Expired |
| City | BLUE ISLAND |
| State | IL |