JACQUELINE M CARLOCK OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047925995

License Status

NOT RENEWED

Business

First Name

JACQUELINE

Middle

Last Name

CARLOCK

Suffix

Business Name

JACQUELINE M CARLOCK OD

Original Issue Date

11/25/1998

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

CRYSTAL LAKE

State

Zip

60014

County

MCHENRY

Ever Disciplined

LastModifiedDate

09/11/2005