SUSAN NICOLE DIEDERICH Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST

License Number

046009913

License Status

NOT RENEWED

Business

First Name

SUSAN

Middle

NICOLE

Last Name

DIEDERICH

Business Name

SUSAN NICOLE DIEDERICH

Original Issue Date

08/29/2006

Effective Date

03/24/2010

Expiration Date

03/31/2012

City

WHITEFISH BAY

State

Zip

53217

County

WISCONSIN

Ever Disciplined

LastModifiedDate

05/16/2012