MICHAEL WILLIAM MENCONI Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047935479

License Status

CANCELLED

Business

First Name

MICHAEL

Middle

WILLIAM

Last Name

MENCONI

Business Name

MICHAEL WILLIAM MENCONI

Original Issue Date

07/13/2009

Effective Date

07/13/2009

Expiration Date

03/31/2010

City

CHICAGO RIDGE

State

Zip

60415

County

COOK

Ever Disciplined

LastModifiedDate

05/04/2010