TRACEY LYNN MANBECK Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****31

License Status

NOT RENEWED

Business

First Name

TRACEY

Middle

LYNN

Last Name

MANBECK

Business Name

TRACEY LYNN MANBECK

Original Issue Date

09/26/1997

Effective Date

08/30/2004

Expiration Date

03/31/2006

City

NAPERVILLE

State

Zip

60540

County

DUPAGE

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/11/2006