GRACE J PAN OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047932625

License Status

CANCELLED

Business

Title

First Name

GRACE

Middle

Last Name

PAN

Business Name

GRACE J PAN OD

Original Issue Date

11/09/2006

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

HOFFMAN ESTATES

State

Zip

60192

County

COOK

Ever Disciplined

LastModifiedDate

05/04/2010