ANDREA J JOHNSON GROTE Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047926358

License Status

NOT RENEWED

Business

First Name

ANDREA

Middle

Last Name

JOHNSON GROTE

Business Name

ANDREA J JOHNSON GROTE

Original Issue Date

09/02/1999

Effective Date

06/09/2004

Expiration Date

03/31/2006

City

CHICAGO

State

Zip

60610

County

COOK

Ever Disciplined

LastModifiedDate

05/11/2006