BRENT C NIELSEN OD - Optometrist License in Illinois | # 047930100

BRENT C NIELSEN OD

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930100

License Status

NOT RENEWED

Business

N

First Name

BRENT

Middle

C

Last Name

NIELSEN

Suffix

OD

Business Name

BRENT C NIELSEN OD

Original Issue Date

04/22/2004

Effective Date

08/08/2006

Expiration Date

03/31/2008

State

IL

Ever Disciplined

N

LastModifiedDate

05/02/2008