MICHAEL CHARLES LOCK OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930512

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

CHARLES

Last Name

LOCK

Suffix

Business Name

MICHAEL CHARLES LOCK OD

Original Issue Date

08/19/2004

Effective Date

08/19/2004

Expiration Date

03/31/2006

City

ORLAND PARK

State

Zip

60462

County

COOK

Ever Disciplined

LastModifiedDate

05/11/2006