TINA R THOMAS OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047931100

License Status

NOT RENEWED

Business

First Name

TINA

Middle

Last Name

THOMAS

Suffix

Business Name

TINA R THOMAS OD

Original Issue Date

04/19/2005

Effective Date

04/19/2005

Expiration Date

03/31/2006

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Ever Disciplined

LastModifiedDate

05/11/2006