JONATHAN EDWARD MICETICH OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047928403

License Status

NOT RENEWED

Business

First Name

JONATHAN

Middle

EDWARD

Last Name

MICETICH

Suffix

Business Name

JONATHAN EDWARD MICETICH OD

Original Issue Date

02/01/2002

Effective Date

02/06/2004

Expiration Date

03/31/2006

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Ever Disciplined

LastModifiedDate

05/11/2006