SUSAN M PENNER OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047928866

License Status

CANCELLED

Business

First Name

SUSAN M

Last Name

PENNER

Suffix

Business Name

SUSAN M PENNER OD

Original Issue Date

08/15/2002

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

ELGIN

State

Zip

60123

County

KANE

Ever Disciplined

LastModifiedDate

05/04/2010