STEPHANIE ROBERTA JOHNSON OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****18

License Status

NOT RENEWED

Business

First Name

STEPHANIE

Middle

ROBERTA

Last Name

JOHNSON

Suffix

Business Name

STEPHANIE ROBERTA JOHNSON OD

Original Issue Date

09/10/2007

Effective Date

03/18/2022

Expiration Date

03/31/2024

City

CHICAGO

State

Zip

60609

County

COOK

Specialty/Qualifier

HOSPITAL/CLINIC

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

02/05/2025