MICHELLE E BERTENTHAL Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047926155

License Status

NOT RENEWED

Business

First Name

MICHELLE E

Last Name

BERTENTHAL

Business Name

MICHELLE E BERTENTHAL

Original Issue Date

03/16/1999

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

09/11/2005