CHAD ALLEN CARLSSON OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****43

License Status

NOT RENEWED

Business

First Name

CHAD

Middle

ALLEN

Last Name

CARLSSON

Suffix

Business Name

CHAD ALLEN CARLSSON OD

Original Issue Date

06/25/2003

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

GILBERT

State

Zip

85297

County

ARIZONA

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/04/2010