JACKSON R BENNETT JR OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047017379

License Status

NOT RENEWED

Business

First Name

JACKSON

Middle

Last Name

BENNETT

Suffix

JR OD

Business Name

JACKSON R BENNETT JR OD

Original Issue Date

09/11/1993

Expiration Date

03/31/1998

City

CHICAGO

State

Zip

60657

County

COOK

Ever Disciplined

LastModifiedDate

09/01/2005