CHARLES S KEFALAS OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047008568

License Status

CANCELLED

Business

First Name

CHARLES

Middle

Last Name

KEFALAS

Suffix

Business Name

CHARLES S KEFALAS OD

Original Issue Date

09/19/1996

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

CHICAGO

State

Zip

60608

County

COOK

Ever Disciplined

LastModifiedDate

05/04/2010