KENT MICHAEL DAUM OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047935408

License Status

CANCELLED

Business

Title

First Name

KENT

Middle

MICHAEL

Last Name

DAUM

Business Name

KENT MICHAEL DAUM OD

Original Issue Date

06/12/2009

Effective Date

06/12/2009

Expiration Date

03/31/2010

City

CHICAGO

State

Zip

60607

County

COOK

Ever Disciplined

LastModifiedDate

05/04/2010