KHYATI MODI AMIN OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047931321

License Status

NOT RENEWED

Business

First Name

KHYATI

Middle

MODI

Last Name

AMIN

Suffix

Business Name

KHYATI MODI AMIN OD

Original Issue Date

08/03/2005

Effective Date

08/03/2005

Expiration Date

03/31/2006

City

CALUMET CITY

State

Zip

60409

County

COOK

Ever Disciplined

LastModifiedDate

05/11/2006