LAMONT MARK SPRAGUE OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****35

License Status

NOT RENEWED

Business

First Name

LAMONT

Middle

MARK

Last Name

SPRAGUE

Suffix

Business Name

LAMONT MARK SPRAGUE OD

Original Issue Date

06/07/1996

Effective Date

02/18/2020

Expiration Date

05/31/2022

City

CRYSTAL LAKE

State

Zip

60014

County

MCHENRY

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022