KHYATI MODI AMIN OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047933015

License Status

NOT RENEWED

Business

First Name

KHYATI

Middle

MODI

Last Name

AMIN

Suffix

Business Name

KHYATI MODI AMIN OD

Original Issue Date

05/09/2007

Effective Date

05/09/2007

Expiration Date

03/31/2008

City

BOLINGBROOK

State

Zip

60440

County

WILL

Ever Disciplined

LastModifiedDate

05/02/2008