BRUCE MICHAEL PORTNOY Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047506563

License Status

CANCELLED

Business

First Name

BRUCE MICHAEL

Last Name

PORTNOY

Business Name

BRUCE MICHAEL PORTNOY

Original Issue Date

10/25/1974

Expiration Date

01/01/1997

City

AURORA

State

Zip

60504

County

DUPAGE

Ever Disciplined

LastModifiedDate

09/01/2005