JORGE A BENAVENTE OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047927794

License Status

NOT RENEWED

Business

First Name

JORGE

Middle

Last Name

BENAVENTE

Suffix

Business Name

JORGE A BENAVENTE OD

Original Issue Date

03/21/2001

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

CHICAGO

State

Zip

60657

County

COOK

Ever Disciplined

LastModifiedDate

09/11/2005