DOMINICK LOUIS OPITZ OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930673

License Status

NOT RENEWED

Business

First Name

DOMINICK

Middle

LOUIS

Last Name

OPITZ

Suffix

Business Name

DOMINICK LOUIS OPITZ OD

Original Issue Date

10/08/2004

Effective Date

10/08/2004

Expiration Date

03/31/2006

City

CHICAGO

State

Zip

60608

County

COOK

Ever Disciplined

LastModifiedDate

05/11/2006