STEPHANIE ROBERTA JOHNSON OD - Optometrist License in Illinois | # 047935003

STEPHANIE ROBERTA JOHNSON OD

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047935003

License Status

CANCELLED

Business

N

First Name

STEPHANIE

Middle

ROBERTA

Last Name

JOHNSON

Suffix

OD

Business Name

STEPHANIE ROBERTA JOHNSON OD

Original Issue Date

01/13/2009

Effective Date

01/13/2009

Expiration Date

03/31/2010

State

IL

Ever Disciplined

N

LastModifiedDate

05/04/2010