KELI ELIZABETH JORDAN GARDNER OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047008857

License Status

NOT RENEWED

Business

First Name

KELI ELIZABETH

Middle

JORDAN

Last Name

GARDNER

Suffix

Business Name

KELI ELIZABETH JORDAN GARDNER OD

Original Issue Date

10/30/1996

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

ROCHELLE

State

Zip

61068

County

OGLE

Ever Disciplined

LastModifiedDate

09/11/2005