JIA LAO OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****04

License Status

CANCELLED

Business

First Name

JIA

Last Name

LAO

Suffix

Business Name

JIA LAO OD

Original Issue Date

09/24/2009

Effective Date

09/24/2009

Expiration Date

03/31/2010

City

CHICAGO

State

Zip

60616

County

COOK

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

01/05/2010