KENNETH J LOSSMAN OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****05

License Status

NOT RENEWED

Business

First Name

KENNETH

Middle

Last Name

LOSSMAN

Suffix

Business Name

KENNETH J LOSSMAN OD

Original Issue Date

08/20/1996

Effective Date

01/22/2018

Expiration Date

09/30/2020

City

LAKE ZURICH

State

Zip

60047

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

01/14/2021