THOMAS RICHARD BENTHIEN Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****46

License Status

NOT RENEWED

Business

First Name

THOMAS RICHARD

Last Name

BENTHIEN

Business Name

THOMAS RICHARD BENTHIEN

Original Issue Date

05/30/1996

Effective Date

03/30/2018

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60642

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021