NGA N PHAN O.D. Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047933851

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

NILES

State

Zip

60714

County

COOK

Ever Disciplined

LastModifiedDate

05/04/2010