LORI SKAROSI JOHNSTON OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****65

License Status

NOT RENEWED

Business

First Name

LORI

Middle

SKAROSI

Last Name

JOHNSTON

Suffix

Business Name

LORI SKAROSI JOHNSTON OD

Original Issue Date

03/14/2000

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/18/2006