STACIE RENEE LYNN OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****39

License Status

NOT RENEWED

Business

First Name

STACIE

Middle

RENEE

Last Name

LYNN

Suffix

Business Name

STACIE RENEE LYNN OD

Original Issue Date

07/30/2001

Effective Date

03/22/2018

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60622

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

01/14/2021