NATHAN DANIEL HARRIS Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****54

License Status

NOT RENEWED

Business

First Name

NATHAN

Middle

DANIEL

Last Name

HARRIS

Business Name

NATHAN DANIEL HARRIS

Original Issue Date

08/23/2002

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

JOLIET

State

Zip

60435

County

WILL

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/11/2005