LAUREN DANIELLE JORDAN OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****23

License Status

NOT RENEWED

Business

Title

First Name

LAUREN

Middle

DANIELLE

Last Name

JORDAN

Business Name

LAUREN DANIELLE JORDAN OD

Original Issue Date

06/06/2013

Effective Date

02/16/2016

Expiration Date

03/31/2018

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/19/2018