TRACEY LYNN MANBECK Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930341

License Status

NOT RENEWED

Business

First Name

TRACEY

Middle

LYNN

Last Name

MANBECK

Business Name

TRACEY LYNN MANBECK

Original Issue Date

06/24/2004

Effective Date

06/24/2004

Expiration Date

03/31/2006

City

ORLAND PARK

State

Zip

60462

County

COOK

Ever Disciplined

LastModifiedDate

05/11/2006