TARA NICOLE VAN DE WYNGAERDE OD Optometrist License verification

Business Entity

ACTIVE

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****64

License Status

ACTIVE

Business

First Name

TARA

Middle

NICOLE

Last Name

VAN DE WYNGAERDE

Suffix

Business Name

TARA NICOLE VAN DE WYNGAERDE OD

Original Issue Date

06/25/2007

Effective Date

02/04/2026

Expiration Date

03/31/2028

City

MENDOTA

State

Zip

61342

County

LA SALLE

Specialty/Qualifier

HOSPITAL/CLINIC

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

02/04/2026