JACK MALLEN - Optometrist License in Illinois | # 047004199

JACK MALLEN

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047004199

License Status

NOT RENEWED

Business

N

First Name

JACK

Last Name

MALLEN

Business Name

JACK MALLEN

Original Issue Date

09/29/1978

Expiration Date

01/01/1997

State

IL

Ever Disciplined

N

LastModifiedDate

09/01/2005