JEROME C LIETZ Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047928508

License Status

CANCELLED

Business

First Name

JEROME C

Last Name

LIETZ

Business Name

JEROME C LIETZ

Original Issue Date

03/29/2002

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

BOLINGBROOK

State

Zip

60440

County

WILL

Ever Disciplined

LastModifiedDate

05/04/2010