LARS J CARLSON Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930609

License Status

NOT RENEWED

Business

First Name

LARS

Middle

Last Name

CARLSON

Business Name

LARS J CARLSON

Original Issue Date

09/22/2004

Effective Date

09/22/2004

Expiration Date

03/31/2006

City

BLOOMINGDALE

State

Zip

60108

County

DUPAGE

Ever Disciplined

LastModifiedDate

05/11/2006