CHARLOTTE F NIELSEN 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

CHARLOTTE F

Last Name

NIELSEN

Suffix

Business Name

CHARLOTTE F NIELSEN OD

Original Issue Date

05/30/1996

Effective Date

01/16/2018

Expiration Date

09/30/2020

City

GRAYSLAKE

State

Zip

60030

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/14/2021