DENNIS M BRTVA Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047407731

License Status

NOT RENEWED

Business

First Name

DENNIS M

Last Name

BRTVA

Business Name

DENNIS M BRTVA

Original Issue Date

01/01/1988

Expiration Date

03/31/1990

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

09/01/2005