SANDRA T PHAN Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****56

License Status

NOT RENEWED

Business

First Name

SANDRA

Middle

Last Name

PHAN

Business Name

SANDRA T PHAN

Original Issue Date

07/13/2009

Effective Date

03/25/2010

Expiration Date

03/31/2012

City

CHICAGO

State

Zip

60602

County

COOK

Controlled Substance Schedule

III IV

Ever Disciplined

LastModifiedDate

05/16/2012