TIMOTHY J DE BOER 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

TIMOTHY J

Last Name

DE BOER

Business Name

TIMOTHY J DE BOER

Original Issue Date

05/07/1996

Effective Date

05/18/2000

Expiration Date

03/31/2000

City

LANSING

State

Zip

60438

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

01/18/2006