LAURA MARIE BLOUNT-ODUM OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****66

License Status

NOT RENEWED

Business

First Name

LAURA

Middle

MARIE

Last Name

BLOUNT-ODUM

Suffix

Business Name

LAURA MARIE BLOUNT-ODUM OD

Original Issue Date

05/07/1996

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

CHICAGO

State

Zip

60603

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/18/2006