JEFFREY THOMAS MANTERNACH OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047935337

License Status

CANCELLED

Business

First Name

JEFFREY

Middle

THOMAS

Last Name

MANTERNACH

Suffix

Business Name

JEFFREY THOMAS MANTERNACH OD

Original Issue Date

05/12/2009

Effective Date

05/12/2009

Expiration Date

03/31/2010

City

CHICAGO

State

Zip

60607

County

COOK

Ever Disciplined

LastModifiedDate

05/04/2010