FREDERICK IRA SEVIN Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****17

License Status

NOT RENEWED

Business

First Name

FREDERICK IRA

Last Name

SEVIN

Business Name

FREDERICK IRA SEVIN

Original Issue Date

09/24/1997

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

CHICAGO

State

Zip

60602

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/11/2005