SLADE A LINDQUIST Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****73

License Status

NOT RENEWED

Business

First Name

SLADE A

Last Name

LINDQUIST

Business Name

SLADE A LINDQUIST

Original Issue Date

04/08/1997

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

GURNEE

State

Zip

60031

County

LAKE

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/11/2005