CHULA LERDVORATAVEE Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047407841

License Status

NOT RENEWED

Business

First Name

CHULA

Last Name

LERDVORATAVEE

Business Name

CHULA LERDVORATAVEE

Original Issue Date

07/20/1988

Expiration Date

03/31/1998

City

ROCKFORD

State

Zip

61102

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

09/01/2005