THOMAS E GUSTAFSON OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****46

License Status

NOT RENEWED

Business

First Name

THOMAS

Middle

Last Name

GUSTAFSON

Suffix

Business Name

THOMAS E GUSTAFSON OD

Original Issue Date

11/19/1996

Effective Date

01/18/2006

Expiration Date

03/31/2008

City

PALATINE

State

Zip

60067

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/02/2008