JORDAN FREDERICK KEITH Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****01

License Status

NOT RENEWED

Business

First Name

JORDAN

Middle

FREDERICK

Last Name

KEITH

Business Name

JORDAN FREDERICK KEITH

Original Issue Date

09/21/2009

Effective Date

03/12/2014

Expiration Date

03/31/2016

City

CHICAGO

State

Zip

60616

County

COOK

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/20/2016