JACKSON R BENNETT JR OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047007379

License Status

NOT RENEWED

Business

First Name

JACKSON

Middle

Last Name

BENNETT

Suffix

JR OD

Business Name

JACKSON R BENNETT JR OD

Original Issue Date

07/22/1992

Expiration Date

03/31/1994

City

DOWNERS GROVE

State

Zip

60515

County

DUPAGE

Ever Disciplined

LastModifiedDate

09/01/2005