WANDA NGA-MAN LAM 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

WANDA

Middle

NGA-MAN

Last Name

LAM

Suffix

Business Name

WANDA NGA-MAN LAM OD

Original Issue Date

09/19/2000

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

CHICAGO

State

Zip

60616

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/18/2006