STEPHANIE ROBERTA JOHNSON OD - Optometrist License in Illinois | # 047007055

STEPHANIE ROBERTA JOHNSON OD

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047007055

License Status

CANCELLED

Business

N

First Name

STEPHANIE

Middle

ROBERTA

Last Name

JOHNSON

Suffix

OD

Business Name

STEPHANIE ROBERTA JOHNSON OD

Original Issue Date

11/17/1978

Expiration Date

01/01/1997

State

IL

Ever Disciplined

N

LastModifiedDate

09/01/2005