CAMTHU MINH PHAM OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047929484

License Status

NOT RENEWED

Business

First Name

CAMTHU

Middle

MINH

Last Name

PHAM

Suffix

Business Name

CAMTHU MINH PHAM OD

Original Issue Date

05/28/2003

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

CHICAGO

State

Zip

60614

County

COOK

Ever Disciplined

LastModifiedDate

09/11/2005