HEATHER MARIE COCKLAN Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****55

License Status

NOT RENEWED

Business

First Name

HEATHER

Middle

MARIE

Last Name

COCKLAN

Business Name

HEATHER MARIE COCKLAN

Original Issue Date

02/01/2002

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

LAKE BLUFF

State

Zip

60044

County

LAKE

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/18/2006