LARS J CARLSON Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****25

License Status

NOT RENEWED

Business

First Name

LARS

Middle

Last Name

CARLSON

Business Name

LARS J CARLSON

Original Issue Date

07/01/2002

Effective Date

03/15/2004

Expiration Date

03/31/2006

City

BERWYN

State

Zip

60402

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/11/2006