BAO QUOC PHAM OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****37

License Status

NOT RENEWED

Business

First Name

BAO

Middle

QUOC

Last Name

PHAM

Suffix

Business Name

BAO QUOC PHAM OD

Original Issue Date

07/02/2012

Effective Date

03/15/2018

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60616

County

COOK

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

01/14/2021