MATTHEW ROGER DE GROOT OD - Optometrist License in Illinois | # 047930042

MATTHEW ROGER DE GROOT OD

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930042

License Status

NOT RENEWED

Business

N

First Name

MATTHEW

Middle

ROGER

Last Name

DE GROOT

Suffix

OD

Business Name

MATTHEW ROGER DE GROOT OD

Original Issue Date

03/18/2004

Effective Date

03/18/2004

Expiration Date

03/31/2006

State

IL

Ever Disciplined

N

LastModifiedDate

05/11/2006