TED KIYOTOSHI NISHIMURA OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST

License Number

046008973

License Status

NOT RENEWED

Business

First Name

TED

Middle

KIYOTOSHI

Last Name

NISHIMURA

Suffix

Business Name

TED KIYOTOSHI NISHIMURA OD

Original Issue Date

02/25/1997

Effective Date

05/11/1998

Expiration Date

03/31/1998

City

BOLINGBROOK

State

Zip

60440

County

WILL

Ever Disciplined

LastModifiedDate

08/31/2005