MICHELLE ROSE WILLENBRING OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047931184

License Status

CANCELLED

Business

First Name

MICHELLE

Middle

ROSE

Last Name

WILLENBRING

Suffix

Business Name

MICHELLE ROSE WILLENBRING OD

Original Issue Date

05/13/2005

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Ever Disciplined

LastModifiedDate

05/04/2010