ROSS W MLSNA OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930181

License Status

NOT RENEWED

Business

First Name

ROSS

Middle

Last Name

MLSNA

Suffix

Business Name

ROSS W MLSNA OD

Original Issue Date

05/26/2004

Effective Date

05/26/2004

Expiration Date

03/31/2006

City

SKOKIE

State

Zip

60076

County

COOK

Ever Disciplined

LastModifiedDate

05/11/2006