KRISTIN LEIGH HAM OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930958

License Status

NOT RENEWED

Business

First Name

KRISTIN

Middle

LEIGH

Last Name

HAM

Suffix

Business Name

KRISTIN LEIGH HAM OD

Original Issue Date

03/10/2005

Effective Date

01/18/2006

Expiration Date

03/31/2008

City

PEORIA

State

Zip

61604

County

PEORIA

Ever Disciplined

LastModifiedDate

05/02/2008