KHAI C VAN Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****47

License Status

NOT RENEWED

Business

First Name

KHAI

Middle

Last Name

VAN

Business Name

KHAI C VAN

Original Issue Date

03/27/2019

Effective Date

03/09/2022

Expiration Date

03/31/2024

City

TINLEY PARK

State

Zip

60477

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025