DIANNE M ANDERSON OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930655

License Status

NOT RENEWED

Business

First Name

DIANNE M

Last Name

ANDERSON

Suffix

Business Name

DIANNE M ANDERSON OD

Original Issue Date

10/05/2004

Effective Date

10/05/2004

Expiration Date

03/31/2006

City

CHICAGO

State

Zip

60609

County

COOK

Ever Disciplined

LastModifiedDate

05/11/2006