KEVIN DAVID GOODWIN OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****49

License Status

NOT RENEWED

Business

Title

First Name

KEVIN

Middle

DAVID

Last Name

GOODWIN

Business Name

KEVIN DAVID GOODWIN OD

Original Issue Date

04/04/2019

Effective Date

04/04/2019

Expiration Date

09/30/2020

City

ST CHARLES

State

Zip

60174

County

KANE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

01/14/2021