DAVID RAY HAISMAN OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930691

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

RAY

Last Name

HAISMAN

Suffix

Business Name

DAVID RAY HAISMAN OD

Original Issue Date

10/27/2004

Effective Date

10/27/2004

Expiration Date

03/31/2006

City

WAUKEGAN

State

Zip

60085

County

LAKE

Ever Disciplined

LastModifiedDate

05/11/2006