GREG R WALDORF OD 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

GREG R

Last Name

WALDORF

Suffix

Business Name

GREG R WALDORF OD

Original Issue Date

04/08/1997

Effective Date

02/18/2004

Expiration Date

03/31/2006

City

LINDENHURST

State

Zip

60046

County

LAKE

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/11/2006