MICHAEL WILLIAM MENCONI Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047935630

License Status

CANCELLED

Business

First Name

MICHAEL

Middle

WILLIAM

Last Name

MENCONI

Business Name

MICHAEL WILLIAM MENCONI

Original Issue Date

08/22/2009

Effective Date

08/22/2009

Expiration Date

03/31/2010

City

GURNEE

State

Zip

60031

County

LAKE

Ever Disciplined

LastModifiedDate

05/04/2010