STACY ANNE TWENHAFEL OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047931600

License Status

NOT RENEWED

Business

First Name

STACY

Middle

ANNE

Last Name

TWENHAFEL

Suffix

Business Name

STACY ANNE TWENHAFEL OD

Original Issue Date

11/07/2005

Effective Date

01/18/2006

Expiration Date

03/31/2008

City

TINLEY PARK

State

Zip

60477

County

COOK

Ever Disciplined

LastModifiedDate

05/02/2008