MATTHEW ROGER DE GROOT OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047935490

License Status

CANCELLED

Business

First Name

MATTHEW

Middle

ROGER

Last Name

DE GROOT

Suffix

Business Name

MATTHEW ROGER DE GROOT OD

Original Issue Date

07/14/2009

Effective Date

07/14/2009

Expiration Date

03/31/2010

City

BEDFORD PARK

State

Zip

60629

County

COOK

Ever Disciplined

LastModifiedDate

05/04/2010