MIRIAM M WELLER Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047928737

License Status

NOT RENEWED

Business

First Name

MIRIAM

Middle

Last Name

WELLER

Business Name

MIRIAM M WELLER

Original Issue Date

06/10/2002

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

SCHAUMBURG

State

Zip

60173

County

COOK

Ever Disciplined

LastModifiedDate

09/11/2005