RANDALL D BURGGRAF OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047933049

License Status

CANCELLED

Business

First Name

RANDALL

Middle

Last Name

BURGGRAF

Suffix

Business Name

RANDALL D BURGGRAF OD

Original Issue Date

05/23/2007

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

YORKVILLE

State

Zip

60560

County

KENDALL

Ever Disciplined

LastModifiedDate

05/04/2010