JORDAN FREDERICK KEITH Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047935823

License Status

CANCELLED

Business

First Name

JORDAN

Middle

FREDERICK

Last Name

KEITH

Business Name

JORDAN FREDERICK KEITH

Original Issue Date

11/03/2009

Effective Date

11/03/2009

Expiration Date

03/31/2010

City

CHICAGO

State

Zip

60616

County

COOK

Ever Disciplined

LastModifiedDate

05/04/2010