CARL M SIMONE OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****59

License Status

NOT RENEWED

Business

First Name

CARL

Middle

Last Name

SIMONE

Suffix

Business Name

CARL M SIMONE OD

Original Issue Date

10/11/2000

Effective Date

03/19/2012

Expiration Date

03/31/2014

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/06/2014