DAVID W JACKSON OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047028452

License Status

NOT RENEWED

Business

First Name

DAVID W

Last Name

JACKSON

Suffix

Business Name

DAVID W JACKSON OD

Original Issue Date

05/08/1996

Expiration Date

03/31/1998

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

09/01/2005