BRADLEY J JORGENSEN Optometrist License verification

Business Entity

INACTIVE

License Type

Optometrist

Description

LICENSED OPTOMETRIST

License Number

046007771

License Status

INACTIVE

Business

First Name

BRADLEY J

Last Name

JORGENSEN

Business Name

BRADLEY J JORGENSEN

Original Issue Date

08/20/1984

Expiration Date

03/31/1988

City

APPLETON

State

Zip

54914

County

WISCONSIN

Ever Disciplined

LastModifiedDate

08/31/2005