STACIE RENEE LYNN OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047931092

License Status

NOT RENEWED

Business

First Name

STACIE

Middle

RENEE

Last Name

LYNN

Suffix

Business Name

STACIE RENEE LYNN OD

Original Issue Date

04/19/2005

Effective Date

05/12/2005

Expiration Date

03/31/2006

City

CHICAGO

State

Zip

60622

County

COOK

Ever Disciplined

LastModifiedDate

05/11/2006