MIKI KITAHATA Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047028170

License Status

NOT RENEWED

Business

First Name

MIKI

Last Name

KITAHATA

Business Name

MIKI KITAHATA

Original Issue Date

07/01/1992

Expiration Date

03/31/1994

City

CRYSTAL LAKE

State

Zip

60014

County

MCHENRY

Ever Disciplined

LastModifiedDate

09/01/2005