TRAVIS MICHAEL BEEN 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

TRAVIS

Middle

MICHAEL

Last Name

BEEN

Business Name

TRAVIS MICHAEL BEEN OD

Original Issue Date

07/22/2016

Effective Date

07/22/2016

Expiration Date

03/31/2018

City

WAUKEGAN

State

Zip

60085

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/19/2018