DAVID RAY HAISMAN OD Optometrist License verification

Business Entity

INACTIVE

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****63

License Status

INACTIVE

Business

First Name

DAVID

Middle

RAY

Last Name

HAISMAN

Suffix

Business Name

DAVID RAY HAISMAN OD

Original Issue Date

03/18/2004

Effective Date

01/18/2006

Expiration Date

03/31/2008

City

MCHENRY

State

Zip

60050

County

MCHENRY

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

02/06/2008