BRUCE ALLAN TEITELBAUM OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047027286

License Status

NOT RENEWED

Business

First Name

BRUCE

Middle

ALLAN

Last Name

TEITELBAUM

Suffix

Business Name

BRUCE ALLAN TEITELBAUM OD

Original Issue Date

11/20/1996

Expiration Date

03/31/1998

City

CHICAGO

State

Zip

60657

County

COOK

Ever Disciplined

LastModifiedDate

09/01/2005