MATTHEW ROGER DE GROOT OD - Optometrist License in Illinois | # 047935490

MATTHEW ROGER DE GROOT OD

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047935490

License Status

CANCELLED

Business

N

First Name

MATTHEW

Middle

ROGER

Last Name

DE GROOT

Suffix

OD

Business Name

MATTHEW ROGER DE GROOT OD

Original Issue Date

07/14/2009

Effective Date

07/14/2009

Expiration Date

03/31/2010

State

IL

Ever Disciplined

N

LastModifiedDate

05/04/2010