LARS J CARLSON Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047929835

License Status

NOT RENEWED

Business

First Name

LARS

Middle

Last Name

CARLSON

Business Name

LARS J CARLSON

Original Issue Date

11/03/2003

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

CHICAGO

State

Zip

60805

County

COOK

Ever Disciplined

LastModifiedDate

09/11/2005