SAMANTHA KRYSTYNE FORDYCE Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST

License Number

046010941

License Status

NOT RENEWED

Business

First Name

SAMANTHA

Middle

KRYSTYNE

Last Name

FORDYCE

Business Name

SAMANTHA KRYSTYNE FORDYCE

Original Issue Date

07/23/2015

Effective Date

02/08/2016

Expiration Date

03/31/2018

City

CHICAGO

State

Zip

60616

County

COOK

Ever Disciplined

LastModifiedDate

06/19/2018