ROSS W MLSNA OD - Optometrist License in Illinois | # 047048133

ROSS W MLSNA OD

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047048133

License Status

NOT RENEWED

Business

N

First Name

ROSS

Middle

W

Last Name

MLSNA

Suffix

OD

Business Name

ROSS W MLSNA OD

Original Issue Date

03/29/1995

Effective Date

06/04/2004

Expiration Date

03/31/2004

State

IL

Ever Disciplined

N

LastModifiedDate

09/11/2005