CRYSTAL S WONG OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****22

License Status

NOT RENEWED

Business

First Name

CRYSTAL

Middle

Last Name

WONG

Suffix

Business Name

CRYSTAL S WONG OD

Original Issue Date

08/18/2004

Effective Date

08/18/2004

Expiration Date

03/31/2006

City

BLOOMINGDALE

State

Zip

60108

County

DUPAGE

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/11/2006