MARY S LILLY OD 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

MARY

Middle

Last Name

LILLY

Suffix

Business Name

MARY S LILLY OD

Original Issue Date

06/10/1996

Effective Date

05/18/2000

Expiration Date

03/31/2000

City

GENEVA

State

Zip

60134

County

KANE

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/11/2005