HENRY R MOORE OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047204204

License Status

NOT RENEWED

Business

Title

First Name

HENRY

Middle

Last Name

MOORE

Business Name

HENRY R MOORE OD

Original Issue Date

02/26/1976

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

CHICAGO

State

Zip

60649

County

COOK

Ever Disciplined

LastModifiedDate

09/11/2005