VASICKA KASIVISVANATHAN Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****57

License Status

NOT RENEWED

Business

First Name

VASICKA

Last Name

KASIVISVANATHAN

Business Name

VASICKA KASIVISVANATHAN

Original Issue Date

05/15/2019

Effective Date

05/15/2019

Expiration Date

09/30/2020

City

TINLEY PARK

State

Zip

60477

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021