DIANE G FORECKI Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****25

License Status

NOT RENEWED

Business

First Name

DIANE G

Last Name

FORECKI

Business Name

DIANE G FORECKI

Original Issue Date

04/11/2008

Effective Date

03/13/2022

Expiration Date

03/31/2024

City

FT MYERS

State

Zip

33913

County

COOK

Specialty/Qualifier

HOSPITAL/CLINIC

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

02/05/2025