BREEZE EVELYN BELLEN OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047931693

License Status

NOT RENEWED

Business

First Name

BREEZE

Middle

EVELYN

Last Name

BELLEN

Suffix

Business Name

BREEZE EVELYN BELLEN OD

Original Issue Date

02/15/2006

Effective Date

02/15/2006

Expiration Date

03/31/2008

City

CHICAGO

State

Zip

60618

County

COOK

Ever Disciplined

LastModifiedDate

05/02/2008