DAWN M BIRCH OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047931035

License Status

NOT RENEWED

Business

First Name

DAWN

Middle

Last Name

BIRCH

Suffix

Business Name

DAWN M BIRCH OD

Original Issue Date

03/14/2005

Effective Date

03/14/2005

Expiration Date

03/31/2006

City

CHICAGO

State

Zip

60635

County

COOK

Ever Disciplined

LastModifiedDate

05/11/2006