IVETTA SUE DACCACHE OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047933052

License Status

NOT RENEWED

Business

First Name

IVETTA

Middle

SUE

Last Name

DACCACHE

Suffix

Business Name

IVETTA SUE DACCACHE OD

Original Issue Date

06/01/2007

Effective Date

06/01/2007

Expiration Date

03/31/2008

City

WASHINGTON

State

Zip

61571

County

TAZEWELL

Ever Disciplined

LastModifiedDate

05/02/2008