ALEX R TAN OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****51

License Status

NOT RENEWED

Business

First Name

ALEX

Middle

Last Name

TAN

Suffix

Business Name

ALEX R TAN OD

Original Issue Date

09/28/2000

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

CHICAGO

State

Zip

60616

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/04/2010