CAROLYN JEAN NEWCOME SPARKS Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****36

License Status

NOT RENEWED

Business

First Name

CAROLYN JEAN

Middle

NEWCOME

Last Name

SPARKS

Business Name

CAROLYN JEAN NEWCOME SPARKS

Original Issue Date

05/07/1996

Effective Date

02/20/2020

Expiration Date

05/31/2022

City

HOMEWOOD

State

Zip

60430

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

07/27/2022