DAVID F MARTIN OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****18

License Status

CANCELLED

Business

First Name

DAVID

Middle

Last Name

MARTIN

Suffix

Business Name

DAVID F MARTIN OD

Original Issue Date

12/16/2005

Effective Date

01/18/2006

Expiration Date

03/31/2008

City

SYCAMORE

State

Zip

60178

County

DEKALB

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

02/24/2006