JEFFREY THOMAS MANTERNACH OD - Optometrist License in Illinois | # 047934205

JEFFREY THOMAS MANTERNACH OD

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047934205

License Status

CANCELLED

Business

N

First Name

JEFFREY

Middle

THOMAS

Last Name

MANTERNACH

Suffix

OD

Business Name

JEFFREY THOMAS MANTERNACH OD

Original Issue Date

05/12/2008

Effective Date

05/12/2008

Expiration Date

03/31/2010

State

IL

Ever Disciplined

N

LastModifiedDate

05/04/2010