SUSAN M PENNER OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047008009

License Status

NOT RENEWED

Business

First Name

SUSAN M

Last Name

PENNER

Suffix

Business Name

SUSAN M PENNER OD

Original Issue Date

09/24/1988

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

ELGIN

State

Zip

60123

County

KANE

Ever Disciplined

LastModifiedDate

09/11/2005