CHAD ALLEN CARLSSON OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047929663

License Status

NOT RENEWED

Business

First Name

CHAD

Middle

ALLEN

Last Name

CARLSSON

Suffix

Business Name

CHAD ALLEN CARLSSON OD

Original Issue Date

09/17/2003

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

CHICAGO

State

Zip

60614

County

COOK

Ever Disciplined

LastModifiedDate

09/11/2005