MICHAEL MALAVE RIVERA OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047926100

License Status

NOT RENEWED

Business

First Name

MICHAEL

Last Name

MALAVE RIVERA

Suffix

Business Name

MICHAEL MALAVE RIVERA OD

Original Issue Date

01/15/1999

Effective Date

05/18/2000

Expiration Date

03/31/2000

City

CHICAGO

State

Zip

60649

County

COOK

Ever Disciplined

LastModifiedDate

09/11/2005