KHYATI MODI AMIN OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047932586

License Status

CANCELLED

Business

First Name

KHYATI

Middle

MODI

Last Name

AMIN

Suffix

Business Name

KHYATI MODI AMIN OD

Original Issue Date

10/24/2006

Effective Date

12/09/2008

Expiration Date

03/31/2010

City

CHICAGO

State

Zip

60607

County

COOK

Ever Disciplined

LastModifiedDate

05/04/2010