GARY W LASKEN Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****40

License Status

NOT RENEWED

Business

First Name

GARY W

Last Name

LASKEN

Business Name

GARY W LASKEN

Original Issue Date

03/22/1996

Effective Date

03/19/2018

Expiration Date

09/30/2020

City

PEORIA

State

Zip

61614

County

PEORIA

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021