KEITH FREDRICK TYLER 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

KEITH

Middle

FREDRICK

Last Name

TYLER

Suffix

Business Name

KEITH FREDRICK TYLER OD

Original Issue Date

06/27/2007

Effective Date

03/22/2010

Expiration Date

03/31/2012

City

CHICAGO

State

Zip

60616

County

COOK

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/16/2012