DANIEL J MEDEMA OD - Optometrist License in Illinois | # 047928657

DANIEL J MEDEMA OD

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047928657

License Status

NOT RENEWED

Business

N

First Name

DANIEL

Middle

J

Last Name

MEDEMA

Suffix

OD

Business Name

DANIEL J MEDEMA OD

Original Issue Date

04/30/2002

Effective Date

06/04/2004

Expiration Date

03/31/2004

State

IL

Ever Disciplined

N

LastModifiedDate

09/11/2005