ANDREW W FORRESTER Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****72

License Status

NOT RENEWED

Business

First Name

ANDREW W

Last Name

FORRESTER

Business Name

ANDREW W FORRESTER

Original Issue Date

09/19/1996

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

PLAINFIELD

State

Zip

60544

County

WILL

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/11/2005