GRACE HASHISAKA-TANAKA OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****68

License Status

NOT RENEWED

Business

First Name

GRACE

Last Name

HASHISAKA-TANAKA

Suffix

Business Name

GRACE HASHISAKA-TANAKA OD

Original Issue Date

11/06/1997

Effective Date

05/18/2000

Expiration Date

03/31/2000

City

CHICAGO

State

Zip

60646

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/18/2006