PETER A RUSSO OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047935258

License Status

CANCELLED

Business

First Name

PETER

Middle

Last Name

RUSSO

Suffix

Business Name

PETER A RUSSO OD

Original Issue Date

04/15/2009

Effective Date

04/15/2009

Expiration Date

03/31/2010

City

VILLA PARK

State

Zip

60181

County

DUPAGE

Ever Disciplined

LastModifiedDate

05/04/2010