ANN LUND MARTIN OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****31

License Status

NOT RENEWED

Business

First Name

ANN

Middle

LUND

Last Name

MARTIN

Suffix

Business Name

ANN LUND MARTIN OD

Original Issue Date

06/22/2009

Effective Date

01/20/2010

Expiration Date

03/31/2012

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/16/2012