MICHAEL ANGELO BERTUCCI OD - Optometrist License in Illinois | # 047930739

MICHAEL ANGELO BERTUCCI OD

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930739

License Status

NOT RENEWED

Business

N

First Name

MICHAEL

Middle

ANGELO

Last Name

BERTUCCI

Suffix

OD

Business Name

MICHAEL ANGELO BERTUCCI OD

Original Issue Date

11/19/2004

Effective Date

11/19/2004

Expiration Date

03/31/2006

State

IL

Ever Disciplined

N

LastModifiedDate

05/11/2006