RABIA N J ANSARI OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930884

License Status

NOT RENEWED

Business

First Name

RABIA

Middle

N J

Last Name

ANSARI

Suffix

Business Name

RABIA N J ANSARI OD

Original Issue Date

02/14/2005

Effective Date

02/14/2005

Expiration Date

03/31/2006

City

CHAMPAIGN

State

Zip

61821

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

05/11/2006