JEFFREY SCOTT PORTER OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930614

License Status

NOT RENEWED

Business

First Name

JEFFREY

Middle

SCOTT

Last Name

PORTER

Suffix

Business Name

JEFFREY SCOTT PORTER OD

Original Issue Date

09/22/2004

Effective Date

09/22/2004

Expiration Date

03/31/2006

City

NILES

State

Zip

60714

County

COOK

Ever Disciplined

LastModifiedDate

05/11/2006