VASANA LERDVORATAVEE OD Optometrist License verification

Business Entity

ACTIVE

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****01

License Status

ACTIVE

Business

First Name

VASANA

Last Name

LERDVORATAVEE

Suffix

Business Name

VASANA LERDVORATAVEE OD

Original Issue Date

11/19/1996

Effective Date

02/04/2026

Expiration Date

03/31/2028

City

OSWEGO

State

Zip

60543

County

KENDALL

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

02/04/2026