DANIEL J MEDEMA OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047933539

License Status

CANCELLED

Business

First Name

DANIEL

Middle

Last Name

MEDEMA

Suffix

Business Name

DANIEL J MEDEMA OD

Original Issue Date

11/01/2007

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

LOMBARD

State

Zip

60148

County

DUPAGE

Ever Disciplined

LastModifiedDate

05/04/2010