SANDRA T PHAN Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST

License Number

046010174

License Status

NOT RENEWED

Business

First Name

SANDRA

Middle

Last Name

PHAN

Business Name

SANDRA T PHAN

Original Issue Date

10/16/2008

Effective Date

03/25/2010

Expiration Date

03/31/2012

City

CHICAGO

State

Zip

60602

County

COOK

Ever Disciplined

LastModifiedDate

05/16/2012