THANH T LE OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****64

License Status

NOT RENEWED

Business

Title

First Name

THANH

Middle

Last Name

Business Name

THANH T LE OD

Original Issue Date

08/15/2012

Effective Date

08/15/2012

Expiration Date

03/31/2014

City

BOURBONNAIS

State

Zip

60914

County

KANKAKEE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/06/2014