L RAYNOLD SANDACK Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****33

License Status

NOT RENEWED

Business

First Name

L RAYNOLD

Last Name

SANDACK

Business Name

L RAYNOLD SANDACK

Original Issue Date

06/22/1999

Effective Date

03/06/2012

Expiration Date

03/31/2014

City

BOURBONNAIS

State

Zip

60914

County

KANKAKEE

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/06/2014