LORI L DEWALL OD 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

LORI L

Last Name

DEWALL

Suffix

Business Name

LORI L DEWALL OD

Original Issue Date

04/17/1996

Effective Date

03/24/2022

Expiration Date

03/31/2024

City

FREEPORT

State

Zip

61032

County

STEPHENSON

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

02/05/2025