JONATHAN EDWARD MICETICH OD - Optometrist License in Illinois | # 047928403

JONATHAN EDWARD MICETICH OD

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047928403

License Status

NOT RENEWED

Business

N

First Name

JONATHAN

Middle

EDWARD

Last Name

MICETICH

Suffix

OD

Business Name

JONATHAN EDWARD MICETICH OD

Original Issue Date

02/01/2002

Effective Date

02/06/2004

Expiration Date

03/31/2006

State

IL

Ever Disciplined

N

LastModifiedDate

05/11/2006