MICHELLE ROSE WILLENBRING 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

MICHELLE

Middle

ROSE

Last Name

WILLENBRING

Suffix

Business Name

MICHELLE ROSE WILLENBRING OD

Original Issue Date

08/04/2003

Effective Date

02/17/2004

Expiration Date

03/31/2006

City

JOLIET

State

Zip

60435

County

WILL

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/11/2006