JILL M BAKOTA OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****21

License Status

NOT RENEWED

Business

First Name

JILL

Middle

Last Name

BAKOTA

Suffix

Business Name

JILL M BAKOTA OD

Original Issue Date

07/06/2010

Effective Date

07/06/2010

Expiration Date

03/31/2012

City

JOLIET

State

Zip

60431

County

WILL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/16/2012