ANSU MARIAM NATHAN - Optometrist License in Illinois | # 046010812

ANSU MARIAM NATHAN

Business Entity

INACTIVE

License Type

Optometrist

Description

LICENSED OPTOMETRIST

License Number

046010812

License Status

INACTIVE

Business

N

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

State

IL

Ever Disciplined

N

LastModifiedDate

01/04/2020