TIFFANY E OWENS OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****08

License Status

NOT RENEWED

Business

First Name

TIFFANY

Middle

Last Name

OWENS

Suffix

Business Name

TIFFANY E OWENS OD

Original Issue Date

07/19/2004

Expiration Date

07/07/2005

City

CHICAGO

State

Zip

60616

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/02/2005