TANYA M PARKS OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****19

License Status

CANCELLED

Business

Title

First Name

TANYA

Middle

Last Name

PARKS

Business Name

TANYA M PARKS OD

Original Issue Date

05/30/1996

Expiration Date

03/31/1998

City

CHICAGO

State

Zip

60649

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/18/2006