SAM DAVID BAKER OD - Optometrist License in Illinois | # 046009651

SAM DAVID BAKER OD

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST

License Number

046009651

License Status

NOT RENEWED

Business

N

First Name

SAM

Middle

DAVID

Last Name

BAKER

Suffix

OD

Business Name

SAM DAVID BAKER OD

Original Issue Date

06/22/2004

Effective Date

03/13/2014

Expiration Date

03/31/2016

State

IL

Ever Disciplined

N

LastModifiedDate

05/20/2016