JEFFREY SCOTT PORTER OD - Optometrist License in Illinois | # 047930614

JEFFREY SCOTT PORTER OD

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930614

License Status

NOT RENEWED

Business

N

First Name

JEFFREY

Middle

SCOTT

Last Name

PORTER

Suffix

OD

Business Name

JEFFREY SCOTT PORTER OD

Original Issue Date

09/22/2004

Effective Date

09/22/2004

Expiration Date

03/31/2006

State

IL

Ever Disciplined

N

LastModifiedDate

05/11/2006