MIRIAM M WELLER Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047928751

License Status

NOT RENEWED

Business

First Name

MIRIAM

Middle

Last Name

WELLER

Business Name

MIRIAM M WELLER

Original Issue Date

06/19/2002

Effective Date

01/18/2006

Expiration Date

03/31/2008

City

LAKE ZURICH

State

Zip

60047

County

LAKE

Ever Disciplined

LastModifiedDate

05/02/2008