MANDEL M BERG Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047925964

License Status

NOT RENEWED

Business

First Name

MANDEL

Middle

Last Name

BERG

Business Name

MANDEL M BERG

Original Issue Date

10/29/1998

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

NILES

State

Zip

60714

County

COOK

Ever Disciplined

LastModifiedDate

09/11/2005