BRUCE MICHAEL PORTNOY Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047206563

License Status

CANCELLED

Business

First Name

BRUCE MICHAEL

Last Name

PORTNOY

Business Name

BRUCE MICHAEL PORTNOY

Original Issue Date

06/25/1974

Expiration Date

01/01/1997

City

CHICAGO

State

Zip

60644

County

COOK

Ever Disciplined

LastModifiedDate

09/01/2005