MICHAEL G BALGEMANN OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047928365

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

Last Name

BALGEMANN

Suffix

Business Name

MICHAEL G BALGEMANN OD

Original Issue Date

01/17/2002

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

OAK PARK

State

Zip

60302

County

COOK

Ever Disciplined

LastModifiedDate

09/11/2005