ANDREA J JOHNSON GROTE Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047927824

License Status

NOT RENEWED

Business

First Name

ANDREA

Middle

Last Name

JOHNSON GROTE

Business Name

ANDREA J JOHNSON GROTE

Original Issue Date

03/29/2001

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

PARK RIDGE

State

Zip

60068

County

COOK

Ever Disciplined

LastModifiedDate

09/11/2005