DAVID A MAZE OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047931402

License Status

CANCELLED

Business

First Name

DAVID

Middle

Last Name

MAZE

Suffix

Business Name

DAVID A MAZE OD

Original Issue Date

08/25/2005

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

VILLA PARK

State

Zip

60540

County

DUPAGE

Ever Disciplined

LastModifiedDate

05/04/2010