NATHAN JAMES BONILLA-WARFORD OD - Optometrist License in Illinois | # 047930784

NATHAN JAMES BONILLA-WARFORD OD

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930784

License Status

NOT RENEWED

Business

N

First Name

NATHAN

Middle

JAMES

Last Name

BONILLA-WARFORD

Suffix

OD

Business Name

NATHAN JAMES BONILLA-WARFORD OD

Original Issue Date

12/10/2004

Effective Date

12/10/2004

Expiration Date

03/31/2006

State

IL

Ever Disciplined

N

LastModifiedDate

05/11/2006