SUSAN M PENNER OD - Optometrist License in Illinois | # 047008009

SUSAN M PENNER OD

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047008009

License Status

NOT RENEWED

Business

N

First Name

SUSAN M

Last Name

PENNER

Suffix

OD

Business Name

SUSAN M PENNER OD

Original Issue Date

09/24/1988

Effective Date

06/04/2004

Expiration Date

03/31/2004

State

IL

Ever Disciplined

N

LastModifiedDate

09/11/2005