KRISTIN LEIGH HAM OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047932359

License Status

NOT RENEWED

Business

First Name

KRISTIN

Middle

LEIGH

Last Name

HAM

Suffix

Business Name

KRISTIN LEIGH HAM OD

Original Issue Date

06/14/2006

Effective Date

06/14/2006

Expiration Date

03/31/2008

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/02/2008