JANICE M PETERSEN EASTY Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****58

License Status

NOT RENEWED

Business

First Name

JANICE M

Last Name

PETERSEN EASTY

Business Name

JANICE M PETERSEN EASTY

Original Issue Date

08/20/1996

Effective Date

02/11/2016

Expiration Date

03/31/2018

City

CRYSTAL LAKE

State

Zip

60014

County

MCHENRY

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

06/19/2018