TOD M DIFFENBAUGH OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047018759

License Status

NOT RENEWED

Business

First Name

TOD M

Last Name

DIFFENBAUGH

Suffix

Business Name

TOD M DIFFENBAUGH OD

Original Issue Date

08/06/1996

Expiration Date

03/31/1998

City

KEWANEE

State

Zip

61440

County

HENRY

Ever Disciplined

LastModifiedDate

09/01/2005