FORUM PURNENDU DAVE Optometrist License verification

Business Entity

ACTIVE

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****32

License Status

ACTIVE

Business

First Name

FORUM

Middle

PURNENDU

Last Name

DAVE

Business Name

FORUM PURNENDU DAVE

Original Issue Date

09/28/2015

Effective Date

03/20/2026

Expiration Date

03/31/2028

City

DES PLAINES

State

Zip

60018

County

COOK

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

03/20/2026