ANSEL T JOHNSON Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047929709

License Status

NOT RENEWED

Business

First Name

ANSEL T

Last Name

JOHNSON

Business Name

ANSEL T JOHNSON

Original Issue Date

09/23/2003

Effective Date

03/25/2004

Expiration Date

03/31/2006

City

CHICAGO

State

Zip

60619

County

COOK

Ever Disciplined

LastModifiedDate

05/11/2006