FREDERIC A BANSER OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047007551

License Status

CANCELLED

Business

First Name

FREDERIC

Middle

Last Name

BANSER

Suffix

Business Name

FREDERIC A BANSER OD

Original Issue Date

12/27/1988

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

CHICAGO

State

Zip

60616

County

COOK

Ever Disciplined

LastModifiedDate

05/04/2010