MARY S LILLY OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****45

License Status

NOT RENEWED

Business

First Name

MARY

Middle

Last Name

LILLY

Suffix

Business Name

MARY S LILLY OD

Original Issue Date

11/21/1996

Expiration Date

03/31/1998

City

ELGIN

State

Zip

60123

County

KANE

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/11/2005