MICHELLE KAY MALCHOW 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

MICHELLE

Middle

KAY

Last Name

MALCHOW

Business Name

MICHELLE KAY MALCHOW

Original Issue Date

06/28/2011

Effective Date

02/05/2014

Expiration Date

03/31/2016

City

GURNEE

State

Zip

60031

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/20/2016