HENRY ETSURO KIKUNAGA OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****19

License Status

NOT RENEWED

Business

First Name

HENRY

Middle

ETSURO

Last Name

KIKUNAGA

Suffix

Business Name

HENRY ETSURO KIKUNAGA OD

Original Issue Date

08/18/2004

Effective Date

01/18/2006

Expiration Date

03/31/2008

City

ELMWOOD PARK

State

Zip

60707

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/02/2008