IVETTA SUE DACCACHE OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047931329

License Status

NOT RENEWED

Business

First Name

IVETTA

Middle

SUE

Last Name

DACCACHE

Suffix

Business Name

IVETTA SUE DACCACHE OD

Original Issue Date

08/05/2005

Effective Date

10/24/2006

Expiration Date

03/31/2008

City

PEKIN

State

Zip

61554

County

TAZEWELL

Ever Disciplined

LastModifiedDate

05/02/2008