KENNETH PORTNOY Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047007059

License Status

CANCELLED

Business

First Name

KENNETH

Last Name

PORTNOY

Business Name

KENNETH PORTNOY

Original Issue Date

10/04/1979

Expiration Date

05/01/1982

City

BUFFALO GROVE

State

Zip

60090

County

COOK

Ever Disciplined

LastModifiedDate

09/01/2005