BRIAN RICHARD BENITZ OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST

License Number

046009192

License Status

NOT RENEWED

Business

First Name

BRIAN

Middle

RICHARD

Last Name

BENITZ

Suffix

Business Name

BRIAN RICHARD BENITZ OD

Original Issue Date

07/21/1999

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

PEORIA

State

Zip

61604

County

PEORIA

Ever Disciplined

LastModifiedDate

09/11/2005