MICHAEL ANGELO BERTUCCI OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930739

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

ANGELO

Last Name

BERTUCCI

Suffix

Business Name

MICHAEL ANGELO BERTUCCI OD

Original Issue Date

11/19/2004

Effective Date

11/19/2004

Expiration Date

03/31/2006

City

DES PLAINES

State

Zip

60018

County

COOK

Ever Disciplined

LastModifiedDate

05/11/2006