SHERENE CHEAM FORT 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

SHERENE

Middle

CHEAM

Last Name

FORT

Suffix

Business Name

SHERENE CHEAM FORT OD

Original Issue Date

02/05/2001

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

CHICAGO

State

Zip

60622

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/11/2005