SCOTT DALE STAATZ OD - Optometrist License in Illinois | # 047018765

SCOTT DALE STAATZ OD

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047018765

License Status

NOT RENEWED

Business

N

First Name

SCOTT DALE

Last Name

STAATZ

Suffix

OD

Business Name

SCOTT DALE STAATZ OD

Original Issue Date

09/19/1996

Expiration Date

03/31/1998

State

IL

Ever Disciplined

N

LastModifiedDate

09/01/2005