MANDEL M BERG - Optometrist License in Illinois | # 047930489

MANDEL M BERG

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930489

License Status

CANCELLED

Business

N

First Name

MANDEL

Middle

M

Last Name

BERG

Business Name

MANDEL M BERG

Original Issue Date

08/13/2004

Effective Date

10/18/2004

Expiration Date

03/31/2006

State

IL

Ever Disciplined

N

LastModifiedDate

09/01/2005