CHARLES S KEFALAS OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047018568

License Status

NOT RENEWED

Business

First Name

CHARLES

Middle

Last Name

KEFALAS

Suffix

Business Name

CHARLES S KEFALAS OD

Original Issue Date

09/19/1996

Effective Date

05/18/2000

Expiration Date

03/31/2000

City

CHICAGO

State

Zip

60629

County

COOK

Ever Disciplined

LastModifiedDate

09/11/2005