JOHN P BELLEN OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****17

License Status

NOT RENEWED

Business

First Name

JOHN

Middle

Last Name

BELLEN

Suffix

Business Name

JOHN P BELLEN OD

Original Issue Date

06/27/2005

Effective Date

04/01/2014

Expiration Date

03/31/2016

City

NILES

State

Zip

60714

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/20/2016