JESSE JACOB FERTIG OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930541

License Status

CANCELLED

Business

First Name

JESSE

Middle

JACOB

Last Name

FERTIG

Suffix

Business Name

JESSE JACOB FERTIG OD

Original Issue Date

08/24/2004

Effective Date

06/24/2005

Expiration Date

03/31/2006

City

CHICAGO

State

Zip

60610

County

COOK

Ever Disciplined

LastModifiedDate

09/01/2005