BETHANY MARIE LEWALLEN OD - Optometrist License in Illinois | # 047926127

BETHANY MARIE LEWALLEN OD

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047926127

License Status

NOT RENEWED

Business

N

First Name

BETHANY

Middle

MARIE

Last Name

LEWALLEN

Suffix

OD

Business Name

BETHANY MARIE LEWALLEN OD

Original Issue Date

02/23/1999

Effective Date

05/18/2000

Expiration Date

03/31/2000

State

IL

Ever Disciplined

N

LastModifiedDate

09/11/2005