BRUCE MICHAEL PORTNOY Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047932493

License Status

CANCELLED

Business

First Name

BRUCE MICHAEL

Last Name

PORTNOY

Business Name

BRUCE MICHAEL PORTNOY

Original Issue Date

09/05/2006

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

WAUKEGAN

State

Zip

60085

County

LAKE

Ever Disciplined

LastModifiedDate

05/04/2010