MISSBA BAWANEY 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

MISSBA

Last Name

BAWANEY

Business Name

MISSBA BAWANEY OD

Original Issue Date

10/25/2006

Effective Date

03/30/2012

Expiration Date

03/31/2014

City

EVANSTON

State

Zip

60202

County

COOK

Specialty/Qualifier

HOSPITAL/CLINIC

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/06/2014