ALICE RENEE DAHL OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047931226

License Status

NOT RENEWED

Business

Title

First Name

ALICE

Middle

RENEE

Last Name

DAHL

Business Name

ALICE RENEE DAHL OD

Original Issue Date

06/09/2005

Effective Date

06/09/2005

Expiration Date

03/31/2006

City

HIGHLAND PARK

State

Zip

60036

County

LAKE

Ever Disciplined

LastModifiedDate

05/11/2006