BRIAN K ORTIZ OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047018802

License Status

NOT RENEWED

Business

First Name

BRIAN

Middle

Last Name

ORTIZ

Suffix

Business Name

BRIAN K ORTIZ OD

Original Issue Date

07/22/1996

Effective Date

05/18/2000

Expiration Date

03/31/2000

City

EVANSTON

State

Zip

60202

County

COOK

Ever Disciplined

LastModifiedDate

09/11/2005