JORGE A BENAVENTE OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047929903

License Status

NOT RENEWED

Business

First Name

JORGE

Middle

Last Name

BENAVENTE

Suffix

Business Name

JORGE A BENAVENTE OD

Original Issue Date

12/11/2003

Effective Date

04/09/2004

Expiration Date

03/31/2006

City

OAK LAWN

State

Zip

60453

County

COOK

Ever Disciplined

LastModifiedDate

05/11/2006