MANDEL M BERG Optometrist License verification

Business Entity

INACTIVE

License Type

Optometrist

Description

LICENSED OPTOMETRIST

License Number

046005714

License Status

INACTIVE

Business

First Name

MANDEL

Middle

Last Name

BERG

Business Name

MANDEL M BERG

Effective Date

03/16/2004

Expiration Date

03/31/2006

City

BUFFALO GROVE

State

Zip

60089

County

LAKE

Ever Disciplined

LastModifiedDate

01/18/2006

Case Number

1993003961

Action

Fine

Discipline Start Date

04/07/1994

Discipline Reason

Practiced without a valid ancillary license.