The holder whose full name is Johnson, Ansel Titus,come from Blue Island IL,hold the Optometrist license(NO.18002452A) which status is Expired.
| Name | Johnson, Ansel Titus |
|---|---|
| License Number | 18002452A |
| License Type | Optometrist |
| License Status | Expired |
| City | Blue Island |
| State | IL |