NATHAN CURTIS DIECKOW OD - Optometrist License in Illinois | # 047935807

NATHAN CURTIS DIECKOW OD

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047935807

License Status

CANCELLED

Business

N

Title

OD

First Name

NATHAN

Middle

CURTIS

Last Name

DIECKOW

Business Name

NATHAN CURTIS DIECKOW OD

Original Issue Date

10/23/2009

Effective Date

10/23/2009

Expiration Date

03/31/2010

State

IL

Ever Disciplined

N

LastModifiedDate

05/04/2010