SHARI-ANN SELANDER STORM 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

SHARI-ANN

Middle

SELANDER

Last Name

STORM

Suffix

Business Name

SHARI-ANN SELANDER STORM OD

Original Issue Date

12/01/1999

Effective Date

04/03/2014

Expiration Date

03/31/2016

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/20/2016