Optometrist
LICENSED OPTOMETRIST
046007970
ACTIVE
N
SCOTT
B
FORD
OD
SCOTT B FORD OD
08/28/1986
03/11/2026
03/31/2028
NILES
IL
60714
COOK
Y
1996002438
Fine
08/27/1996
Failed to have an ancillary license for one location.