TIFFANY E OWENS OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIC LIMITED RESIDENCY

License Number

222000011

License Status

NOT RENEWED

Business

First Name

TIFFANY

Middle

Last Name

OWENS

Suffix

Business Name

TIFFANY E OWENS OD

Original Issue Date

07/19/2004

Effective Date

07/19/2004

Expiration Date

07/07/2005

City

CHICAGO

State

Zip

60616

County

COOK

Ever Disciplined

LastModifiedDate

09/19/2005