MICHELLE DIANE BREHM OD Optometrist License verification

Business Entity

INACTIVE

License Type

Optometrist

Description

LICENSED OPTOMETRIST

License Number

046010307

License Status

INACTIVE

Business

Title

First Name

MICHELLE

Middle

DIANE

Last Name

BREHM

Business Name

MICHELLE DIANE BREHM OD

Original Issue Date

11/19/2009

Effective Date

03/14/2012

Expiration Date

03/31/2014

City

CHICAGO

State

Zip

60647

County

COOK

Ever Disciplined

LastModifiedDate

01/09/2014