MARK M JACQUOT OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047929081

License Status

NOT RENEWED

Business

First Name

MARK

Middle

Last Name

JACQUOT

Suffix

Business Name

MARK M JACQUOT OD

Original Issue Date

10/18/2002

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

ELGIN

State

Zip

60123

County

KANE

Ever Disciplined

LastModifiedDate

09/11/2005