KHYATI MODI AMIN OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047934410

License Status

CANCELLED

Business

First Name

KHYATI

Middle

MODI

Last Name

AMIN

Suffix

Business Name

KHYATI MODI AMIN OD

Original Issue Date

07/18/2008

Effective Date

07/18/2008

Expiration Date

03/31/2010

City

OAK BROOK

State

Zip

60523

County

DUPAGE

Ever Disciplined

LastModifiedDate

05/04/2010