CARRIE SPENCER SYPHERD OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****11

License Status

NOT RENEWED

Business

First Name

CARRIE

Middle

SPENCER

Last Name

SYPHERD

Suffix

Business Name

CARRIE SPENCER SYPHERD OD

Original Issue Date

06/13/2005

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

AURORA

State

Zip

60504

County

DUPAGE

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/04/2010