NGA N PHAN O.D. Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047933850

License Status

CANCELLED

Business

Title

O.D.

First Name

NGA

Middle

Last Name

PHAN

Business Name

NGA N PHAN O.D.

Original Issue Date

03/13/2008

Effective Date

03/13/2008

Expiration Date

03/31/2010

City

VERNON HILLS

State

Zip

60061

County

LAKE

Ever Disciplined

LastModifiedDate

05/04/2010