EDWARD D AUGDAHL OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****20

License Status

NOT RENEWED

Business

First Name

EDWARD D

Last Name

AUGDAHL

Suffix

Business Name

EDWARD D AUGDAHL OD

Original Issue Date

04/04/1996

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/11/2005