CHARLES G VICKERS OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****49

License Status

NOT RENEWED

Business

First Name

CHARLES G

Last Name

VICKERS

Suffix

Business Name

CHARLES G VICKERS OD

Original Issue Date

04/04/1996

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

CHICAGO

State

Zip

60616

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/11/2005