DALE J SWETLISHNOFF OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****72

License Status

NOT RENEWED

Business

Title

First Name

DALE

Middle

Last Name

SWETLISHNOFF

Business Name

DALE J SWETLISHNOFF OD

Original Issue Date

06/10/1998

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/18/2006