ELILTA BEREKETAB OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047929525

License Status

NOT RENEWED

Business

First Name

ELILTA

Last Name

BEREKETAB

Suffix

Business Name

ELILTA BEREKETAB OD

Original Issue Date

08/01/2003

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

JOLIET

State

Zip

60435

County

WILL

Ever Disciplined

LastModifiedDate

09/11/2005