DANIEL J MEDEMA OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047038031

License Status

NOT RENEWED

Business

First Name

DANIEL

Middle

Last Name

MEDEMA

Suffix

Business Name

DANIEL J MEDEMA OD

Original Issue Date

06/20/1995

Effective Date

05/18/2000

Expiration Date

03/31/2000

City

ST CHARLES

State

Zip

60174

County

KANE

Ever Disciplined

LastModifiedDate

09/11/2005