CHELISE NICOLE FIRMIN OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****63

License Status

NOT RENEWED

Business

Title

First Name

CHELISE

Middle

NICOLE

Last Name

FIRMIN

Business Name

CHELISE NICOLE FIRMIN OD

Original Issue Date

04/07/2010

Effective Date

04/07/2010

Expiration Date

03/31/2012

City

CHICAGO

State

Zip

60631

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/16/2012