KRISTIN E LARSON OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047929011

License Status

CANCELLED

Business

First Name

KRISTIN

Middle

Last Name

LARSON

Suffix

Business Name

KRISTIN E LARSON OD

Original Issue Date

09/26/2002

Effective Date

05/22/2003

Expiration Date

03/31/2004

City

CHICAGO

State

Zip

60634

County

COOK

Ever Disciplined

LastModifiedDate

09/01/2005