STEPHANIE ROBERTA JOHNSON OD - Optometrist License in Illinois | # 047207055

STEPHANIE ROBERTA JOHNSON OD

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047207055

License Status

NOT RENEWED

Business

N

First Name

STEPHANIE

Middle

ROBERTA

Last Name

JOHNSON

Suffix

OD

Business Name

STEPHANIE ROBERTA JOHNSON OD

Original Issue Date

03/09/1991

Effective Date

06/04/2004

Expiration Date

03/31/2004

State

IL

Ever Disciplined

N

LastModifiedDate

09/11/2005