JILL M BAKOTA OD Optometrist License verification

Business Entity

INACTIVE

License Type

Optometrist

Description

LICENSED OPTOMETRIST

License Number

046010341

License Status

INACTIVE

Business

First Name

JILL

Middle

Last Name

BAKOTA

Suffix

Business Name

JILL M BAKOTA OD

Original Issue Date

06/28/2010

Effective Date

03/04/2014

Expiration Date

03/31/2016

City

FORTSON

State

Zip

31808

Ever Disciplined

LastModifiedDate

02/03/2016