PHDRA N RANJBAR OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****68

License Status

NOT RENEWED

Business

Title

First Name

PHDRA

Middle

Last Name

RANJBAR

Business Name

PHDRA N RANJBAR OD

Original Issue Date

10/05/2010

Effective Date

10/05/2010

Expiration Date

03/31/2012

City

CHICAGO

State

Zip

60629

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/16/2012