ANSU MARIAM NATHAN Optometrist License verification

Business Entity

INACTIVE

License Type

Optometrist

Description

LICENSED OPTOMETRIST

License Number

046010812

License Status

INACTIVE

Business

First Name

ANSU

Middle

MARIAM

Last Name

NATHAN

Business Name

ANSU MARIAM NATHAN

Original Issue Date

06/12/2014

Effective Date

02/01/2018

Expiration Date

09/30/2020

City

MOUNT PROSPECT

State

Zip

60056

County

COOK

Ever Disciplined

LastModifiedDate

01/04/2020