RANDY D FORD OD - Optometrist License in Illinois | # 047926106

RANDY D FORD OD

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047926106

License Status

CANCELLED

Business

N

First Name

RANDY

Middle

D

Last Name

FORD

Suffix

OD

Business Name

RANDY D FORD OD

Original Issue Date

01/25/1999

Effective Date

09/22/2004

Expiration Date

03/31/2006

State

IL

Ever Disciplined

N

LastModifiedDate

01/18/2006