RANDY D FORD OD - Optometrist License in Illinois | # 047929442

RANDY D FORD OD

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047929442

License Status

NOT RENEWED

Business

N

First Name

RANDY

Middle

D

Last Name

FORD

Suffix

OD

Business Name

RANDY D FORD OD

Original Issue Date

04/21/2003

Effective Date

06/04/2004

Expiration Date

03/31/2004

State

IL

Ever Disciplined

N

LastModifiedDate

09/11/2005