DAWN M BIRCH OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930649

License Status

NOT RENEWED

Business

First Name

DAWN

Middle

Last Name

BIRCH

Suffix

Business Name

DAWN M BIRCH OD

Original Issue Date

10/04/2004

Effective Date

10/04/2004

Expiration Date

03/31/2006

City

GURNEE

State

Zip

60031

County

LAKE

Ever Disciplined

LastModifiedDate

05/11/2006