MARY ANN BIELENBERG Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****90

License Status

NOT RENEWED

Business

First Name

MARY ANN

Last Name

BIELENBERG

Business Name

MARY ANN BIELENBERG

Original Issue Date

08/04/2008

Effective Date

03/10/2010

Expiration Date

03/31/2012

City

BOURBONNAIS

State

Zip

60914

County

KANKAKEE

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/16/2012