THOMAS A WENNERBERG 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

THOMAS A

Last Name

WENNERBERG

Business Name

THOMAS A WENNERBERG

Original Issue Date

09/26/2000

Effective Date

03/20/2020

Expiration Date

05/31/2022

City

LAGRANGE PARK

State

Zip

60526

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

07/27/2022