TRAVIS S PARK OD - Optometrist License in Illinois | # 047935223

TRAVIS S PARK OD

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047935223

License Status

CANCELLED

Business

N

First Name

TRAVIS

Middle

S

Last Name

PARK

Suffix

OD

Business Name

TRAVIS S PARK OD

Original Issue Date

04/08/2009

Effective Date

04/08/2009

Expiration Date

03/31/2010

State

IL

Ever Disciplined

N

LastModifiedDate

05/04/2010