JOSHUA LEE KORSGARDEN OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****06

License Status

NOT RENEWED

Business

First Name

JOSHUA

Middle

LEE

Last Name

KORSGARDEN

Suffix

Business Name

JOSHUA LEE KORSGARDEN OD

Original Issue Date

07/19/2004

Effective Date

07/19/2004

Expiration Date

03/31/2006

City

DE KALB

State

Zip

60115

County

DEKALB

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/11/2006