DANIEL J MEDEMA OD - Optometrist License in Illinois | # 047931617

DANIEL J MEDEMA OD

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047931617

License Status

NOT RENEWED

Business

N

First Name

DANIEL

Middle

J

Last Name

MEDEMA

Suffix

OD

Business Name

DANIEL J MEDEMA OD

Original Issue Date

11/09/2005

Effective Date

11/09/2005

Expiration Date

03/31/2006

State

IL

Ever Disciplined

N

LastModifiedDate

05/11/2006