STACEY LYNN RAMIRO 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

STACEY

Middle

LYNN

Last Name

RAMIRO

Business Name

STACEY LYNN RAMIRO OD

Original Issue Date

03/04/2004

Effective Date

04/12/2010

Expiration Date

03/31/2012

City

OAKBROOK TERRACE

State

Zip

60181

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/16/2012