MICHAEL SCULLEY OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930275

License Status

NOT RENEWED

Business

First Name

MICHAEL

Last Name

SCULLEY

Suffix

Business Name

MICHAEL SCULLEY OD

Original Issue Date

06/07/2004

Effective Date

06/07/2004

Expiration Date

03/31/2006

City

CHICAGO

State

Zip

60607

County

COOK

Ever Disciplined

LastModifiedDate

05/11/2006