RANDALL D BURGGRAF OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047932595

License Status

NOT RENEWED

Business

First Name

RANDALL

Middle

Last Name

BURGGRAF

Suffix

Business Name

RANDALL D BURGGRAF OD

Original Issue Date

10/24/2006

Effective Date

10/24/2006

Expiration Date

03/31/2008

City

CHICAGO

State

Zip

60607

County

COOK

Ever Disciplined

LastModifiedDate

05/02/2008