MARK M JACQUOT OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047929245

License Status

NOT RENEWED

Business

First Name

MARK

Middle

Last Name

JACQUOT

Suffix

Business Name

MARK M JACQUOT OD

Original Issue Date

01/29/2003

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

BLOOMINGDALE

State

Zip

60108

County

DUPAGE

Ever Disciplined

LastModifiedDate

09/11/2005