CHAD T MILLSAP OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047934809

License Status

CANCELLED

Business

First Name

CHAD

Middle

Last Name

MILLSAP

Suffix

Business Name

CHAD T MILLSAP OD

Original Issue Date

10/30/2008

Effective Date

10/30/2008

Expiration Date

03/31/2010

City

CHICAGO

State

Zip

60619

County

COOK

Ever Disciplined

LastModifiedDate

05/04/2010