LISA BETH SPEVACEK OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****56

License Status

NOT RENEWED

Business

Title

First Name

LISA

Middle

BETH

Last Name

SPEVACEK

Business Name

LISA BETH SPEVACEK OD

Original Issue Date

08/24/2005

Effective Date

08/24/2005

Expiration Date

03/31/2006

City

JOLIET

State

Zip

60435

County

WILL

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/11/2006