SCOTT DALE STAATZ OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047018765

License Status

NOT RENEWED

Business

First Name

SCOTT DALE

Last Name

STAATZ

Suffix

Business Name

SCOTT DALE STAATZ OD

Original Issue Date

09/19/1996

Expiration Date

03/31/1998

City

ORLAND PARK

State

Zip

60462

County

COOK

Ever Disciplined

LastModifiedDate

09/01/2005