KRISTIN E LARSON OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047929464

License Status

CANCELLED

Business

First Name

KRISTIN

Middle

Last Name

LARSON

Suffix

Business Name

KRISTIN E LARSON OD

Original Issue Date

05/20/2003

Effective Date

02/02/2005

Expiration Date

03/31/2006

City

CARPENTERSVILLE

State

Zip

60110

County

KANE

Ever Disciplined

LastModifiedDate

09/01/2005