DAVID SIMON Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****44

License Status

NOT RENEWED

Business

First Name

DAVID

Last Name

SIMON

Business Name

DAVID SIMON

Original Issue Date

10/21/1996

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

CALUMET CITY

State

Zip

60409

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/11/2005