MICHAEL G BALGEMANN OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047926686

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

Last Name

BALGEMANN

Suffix

Business Name

MICHAEL G BALGEMANN OD

Original Issue Date

12/30/1999

Effective Date

05/19/2003

Expiration Date

03/31/2000

City

CHICAGO

State

Zip

60647

County

COOK

Ever Disciplined

LastModifiedDate

09/11/2005