STACY ANNE TWENHAFEL OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047931876

License Status

NOT RENEWED

Business

First Name

STACY

Middle

ANNE

Last Name

TWENHAFEL

Suffix

Business Name

STACY ANNE TWENHAFEL OD

Original Issue Date

03/30/2006

Effective Date

03/30/2006

Expiration Date

03/31/2008

City

HOMER GLEN

State

Zip

60491

County

WILL

Ever Disciplined

LastModifiedDate

05/02/2008