KHYATI MODI AMIN OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047931291

License Status

NOT RENEWED

Business

First Name

KHYATI

Middle

MODI

Last Name

AMIN

Suffix

Business Name

KHYATI MODI AMIN OD

Original Issue Date

07/25/2005

Effective Date

07/25/2005

Expiration Date

03/31/2006

City

ST CHARLES

State

Zip

60174

County

KANE

Ever Disciplined

LastModifiedDate

05/11/2006