JORDON BELLER Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****08

License Status

NOT RENEWED

Business

First Name

JORDON

Last Name

BELLER

Business Name

JORDON BELLER

Original Issue Date

06/21/1996

Effective Date

03/11/2004

Expiration Date

03/31/2006

City

LAGRANGE

State

Zip

60525

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/11/2006