LORETTA LYNN DEKOSTER OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****10

License Status

NOT RENEWED

Business

First Name

LORETTA

Middle

LYNN

Last Name

DEKOSTER

Suffix

Business Name

LORETTA LYNN DEKOSTER OD

Original Issue Date

03/09/1999

Effective Date

05/18/2000

Expiration Date

03/31/2000

City

WILMETTE

State

Zip

60091

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/18/2006