RICHARD SCOTT CARLSON Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****53

License Status

NOT RENEWED

Business

First Name

RICHARD

Middle

SCOTT

Last Name

CARLSON

Business Name

RICHARD SCOTT CARLSON

Original Issue Date

08/16/2002

Effective Date

06/02/2006

Expiration Date

03/31/2008

City

ARLINGTON HEIGHTS

State

Zip

60005

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/02/2008