JESSE JACOB FERTIG OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930390

License Status

NOT RENEWED

Business

First Name

JESSE

Middle

JACOB

Last Name

FERTIG

Suffix

Business Name

JESSE JACOB FERTIG OD

Original Issue Date

06/30/2004

Effective Date

11/06/2006

Expiration Date

03/31/2008

City

LINDENHURST

State

Zip

60046

County

LAKE

Ever Disciplined

LastModifiedDate

05/02/2008