NICOLE ANN BLOOMQUIST OD Optometrist License verification

Business Entity

INACTIVE

License Type

Optometrist

Description

LICENSED OPTOMETRIST

License Number

046009190

License Status

INACTIVE

Business

First Name

NICOLE

Middle

ANN

Last Name

BLOOMQUIST

Suffix

Business Name

NICOLE ANN BLOOMQUIST OD

Original Issue Date

07/20/1999

Effective Date

02/27/2004

Expiration Date

03/31/2004

City

GURNEE

State

Zip

60031

County

LAKE

Ever Disciplined

LastModifiedDate

09/11/2005