MORTON FORD OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930324

License Status

NOT RENEWED

Business

First Name

MORTON

Last Name

FORD

Suffix

Business Name

MORTON FORD OD

Original Issue Date

06/23/2004

Effective Date

06/23/2004

Expiration Date

03/31/2006

City

MOUNT PROSPECT

State

Zip

60056

County

COOK

Ever Disciplined

LastModifiedDate

05/11/2006