MICHELLE E BERTENTHAL Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST

License Number

046008842

License Status

NOT RENEWED

Business

First Name

MICHELLE E

Last Name

BERTENTHAL

Business Name

MICHELLE E BERTENTHAL

Original Issue Date

09/16/1995

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

FORSYTHE

State

Zip

62535

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

09/11/2005