ANSEL T JOHNSON Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047929117

License Status

NOT RENEWED

Business

First Name

ANSEL T

Last Name

JOHNSON

Business Name

ANSEL T JOHNSON

Original Issue Date

10/25/2002

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

CHICAGO

State

Zip

60621

County

COOK

Ever Disciplined

LastModifiedDate

09/11/2005