BREEZE EVELYN BELLEN OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****76

License Status

NOT RENEWED

Business

First Name

BREEZE

Middle

EVELYN

Last Name

BELLEN

Suffix

Business Name

BREEZE EVELYN BELLEN OD

Original Issue Date

12/09/2008

Effective Date

03/22/2018

Expiration Date

09/30/2020

City

MELROSE PARK

State

Zip

60160

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

01/14/2021