BRENT C NIELSEN OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047006012

License Status

CANCELLED

Business

First Name

BRENT

Middle

Last Name

NIELSEN

Suffix

Business Name

BRENT C NIELSEN OD

Original Issue Date

11/07/1985

Expiration Date

03/31/1988

City

ALEDO

State

Zip

61231

County

MERCER

Ever Disciplined

LastModifiedDate

09/01/2005