SAM DAVID BAKER OD - Optometrist License in Illinois | # 047935380

SAM DAVID BAKER OD

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047935380

License Status

CANCELLED

Business

N

First Name

SAM

Middle

DAVID

Last Name

BAKER

Suffix

OD

Business Name

SAM DAVID BAKER OD

Original Issue Date

06/02/2009

Effective Date

06/02/2009

Expiration Date

03/31/2010

State

IL

Ever Disciplined

N

LastModifiedDate

05/04/2010