MARTIN R DORNER Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****71

License Status

CANCELLED

Business

First Name

MARTIN R

Last Name

DORNER

Business Name

MARTIN R DORNER

Original Issue Date

07/07/1996

Effective Date

01/18/2006

Expiration Date

03/31/2008

City

LISLE

State

Zip

60532

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/10/2008