NATHAN JAMES BONILLA-WARFORD OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930421

License Status

NOT RENEWED

Business

First Name

NATHAN

Middle

JAMES

Last Name

BONILLA-WARFORD

Suffix

Business Name

NATHAN JAMES BONILLA-WARFORD OD

Original Issue Date

08/12/2004

Effective Date

08/12/2004

Expiration Date

03/31/2006

City

CHICAGO

State

Zip

60614

County

COOK

Ever Disciplined

LastModifiedDate

05/11/2006