ALEX R TAN OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047934667

License Status

CANCELLED

Business

First Name

ALEX

Middle

Last Name

TAN

Suffix

Business Name

ALEX R TAN OD

Original Issue Date

09/19/2008

Effective Date

09/19/2008

Expiration Date

03/31/2010

City

RIVER FOREST

State

Zip

60305

County

COOK

Ever Disciplined

LastModifiedDate

05/04/2010