JEFFREY A SMITH Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****70

License Status

NOT RENEWED

Business

First Name

JEFFREY A

Last Name

SMITH

Business Name

JEFFREY A SMITH

Original Issue Date

07/11/1996

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

ELGIN

State

Zip

60123

County

KANE

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/11/2005