BRENT C NIELSEN OD - Optometrist License in Illinois | # 047006012

BRENT C NIELSEN OD

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047006012

License Status

CANCELLED

Business

N

First Name

BRENT

Middle

C

Last Name

NIELSEN

Suffix

OD

Business Name

BRENT C NIELSEN OD

Original Issue Date

11/07/1985

Expiration Date

03/31/1988

State

IL

Ever Disciplined

N

LastModifiedDate

09/01/2005