CAMTHU MINH PHAM OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047928495

License Status

NOT RENEWED

Business

First Name

CAMTHU

Middle

MINH

Last Name

PHAM

Suffix

Business Name

CAMTHU MINH PHAM OD

Original Issue Date

03/14/2002

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

09/11/2005