CHAD T MILLSAP OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047929425

License Status

NOT RENEWED

Business

First Name

CHAD

Middle

Last Name

MILLSAP

Suffix

Business Name

CHAD T MILLSAP OD

Original Issue Date

04/11/2003

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

OAK PARK

State

Zip

60301

County

COOK

Ever Disciplined

LastModifiedDate

09/11/2005