THERESE MARIE PORRETTA Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047928053

License Status

NOT RENEWED

Business

First Name

THERESE

Middle

MARIE

Last Name

PORRETTA

Business Name

THERESE MARIE PORRETTA

Original Issue Date

08/15/2001

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

DE KALB

State

Zip

60115

County

DEKALB

Ever Disciplined

LastModifiedDate

09/11/2005