ELILTA BEREKETAB OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930500

License Status

NOT RENEWED

Business

First Name

ELILTA

Last Name

BEREKETAB

Suffix

Business Name

ELILTA BEREKETAB OD

Original Issue Date

08/17/2004

Effective Date

01/18/2006

Expiration Date

03/31/2008

City

PERU

State

Zip

61354

County

LA SALLE

Ever Disciplined

LastModifiedDate

05/02/2008