NICOLE J DECKER OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****29

License Status

NOT RENEWED

Business

Title

First Name

NICOLE

Middle

Last Name

DECKER

Business Name

NICOLE J DECKER OD

Original Issue Date

08/04/2006

Effective Date

02/20/2020

Expiration Date

09/30/2020

City

CLARENDON HILLS

State

Zip

60514

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

01/14/2021