SETH BENJAMIN ANDERSON 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

SETH

Middle

BENJAMIN

Last Name

ANDERSON

Business Name

SETH BENJAMIN ANDERSON OD

Original Issue Date

09/10/2020

Effective Date

09/10/2020

Expiration Date

05/31/2022

City

CHICAGO

State

Zip

60632

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022