CHARLES BAILEY GOODMAN Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047934977

License Status

CANCELLED

Business

First Name

CHARLES

Middle

BAILEY

Last Name

GOODMAN

Business Name

CHARLES BAILEY GOODMAN

Original Issue Date

12/31/2008

Effective Date

12/31/2008

Expiration Date

03/31/2010

City

CHICAGO

State

Zip

60643

County

COOK

Ever Disciplined

LastModifiedDate

05/04/2010