BRENT C NIELSEN OD - Optometrist License in Illinois | # 047932041

BRENT C NIELSEN OD

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047932041

License Status

CANCELLED

Business

N

First Name

BRENT

Middle

C

Last Name

NIELSEN

Suffix

OD

Business Name

BRENT C NIELSEN OD

Original Issue Date

04/18/2006

Effective Date

01/10/2008

Expiration Date

03/31/2010

State

IL

Ever Disciplined

N

LastModifiedDate

05/04/2010