MICHELE LEE BENCKS Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****27

License Status

NOT RENEWED

Business

First Name

MICHELE

Middle

LEE

Last Name

BENCKS

Business Name

MICHELE LEE BENCKS

Original Issue Date

07/03/2002

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

CHICAGO

State

Zip

60649

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/11/2005