SCOTT B FORD OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047926614

License Status

NOT RENEWED

Business

First Name

SCOTT

Middle

Last Name

FORD

Suffix

Business Name

SCOTT B FORD OD

Original Issue Date

11/22/1999

Effective Date

05/18/2000

Expiration Date

03/31/2000

City

ELK GROVE VILLAGE

State

Zip

60007

County

COOK

Ever Disciplined

LastModifiedDate

09/11/2005