ROSS W MLSNA OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047048133

License Status

NOT RENEWED

Business

First Name

ROSS

Middle

Last Name

MLSNA

Suffix

Business Name

ROSS W MLSNA OD

Original Issue Date

03/29/1995

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

SANDWICH

State

Zip

60548

County

DEKALB

Ever Disciplined

LastModifiedDate

09/11/2005