STACY ANNE TWENHAFEL OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930900

License Status

NOT RENEWED

Business

First Name

STACY

Middle

ANNE

Last Name

TWENHAFEL

Suffix

Business Name

STACY ANNE TWENHAFEL OD

Original Issue Date

02/17/2005

Effective Date

02/17/2005

Expiration Date

03/31/2006

City

HICKORY HILLS

State

Zip

60457

County

COOK

Ever Disciplined

LastModifiedDate

05/11/2006