MATTHEW ROGER DE GROOT OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930042

License Status

NOT RENEWED

Business

First Name

MATTHEW

Middle

ROGER

Last Name

DE GROOT

Suffix

Business Name

MATTHEW ROGER DE GROOT OD

Original Issue Date

03/18/2004

Effective Date

03/18/2004

Expiration Date

03/31/2006

City

DES PLAINES

State

Zip

60016

County

COOK

Ever Disciplined

LastModifiedDate

05/11/2006