SAMALA KHAN OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****27

License Status

NOT RENEWED

Business

First Name

SAMALA

Last Name

KHAN

Suffix

Business Name

SAMALA KHAN OD

Original Issue Date

08/26/2004

Effective Date

08/26/2004

Expiration Date

03/31/2006

City

CHICAGO

State

Zip

60616

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/11/2006