RICHARD JOHN DYKSTRA OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****71

License Status

NOT RENEWED

Business

First Name

RICHARD

Middle

JOHN

Last Name

DYKSTRA

Suffix

Business Name

RICHARD JOHN DYKSTRA OD

Original Issue Date

06/13/1996

Effective Date

03/25/2016

Expiration Date

03/31/2018

City

WORTH

State

Zip

60482

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

06/19/2018