STACEY LYNN RAMIRO OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****38

License Status

NOT RENEWED

Business

Title

First Name

STACEY

Middle

LYNN

Last Name

RAMIRO

Business Name

STACEY LYNN RAMIRO OD

Original Issue Date

11/21/2003

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

01/18/2006