TINA R THOMAS OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930389

License Status

NOT RENEWED

Business

First Name

TINA

Middle

Last Name

THOMAS

Suffix

Business Name

TINA R THOMAS OD

Original Issue Date

06/30/2004

Effective Date

06/30/2004

Expiration Date

03/31/2006

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/11/2006