KAITLYN SPRAGUE KELLER OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****21

License Status

NOT RENEWED

Business

First Name

KAITLYN

Middle

SPRAGUE

Last Name

KELLER

Suffix

Business Name

KAITLYN SPRAGUE KELLER OD

Original Issue Date

06/04/2012

Effective Date

06/04/2012

Expiration Date

03/31/2014

City

CHICAGO

State

Zip

60616

County

COOK

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/06/2014