DENNIS M BRTVA Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047307731

License Status

NOT RENEWED

Business

First Name

DENNIS M

Last Name

BRTVA

Business Name

DENNIS M BRTVA

Original Issue Date

08/15/1987

Expiration Date

03/31/1988

City

PEORIA

State

Zip

61614

County

PEORIA

Ever Disciplined

LastModifiedDate

09/01/2005