BRENT C NIELSEN OD - Optometrist License in Illinois | # 047930182

BRENT C NIELSEN OD

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930182

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

05/26/2004

Effective Date

05/26/2004

Expiration Date

03/31/2006

State

IL

Ever Disciplined

N

LastModifiedDate

05/11/2006