KELLY MARIE KEANE OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****76

License Status

NOT RENEWED

Business

Title

First Name

KELLY

Middle

MARIE

Last Name

KEANE

Business Name

KELLY MARIE KEANE OD

Original Issue Date

08/28/2013

Effective Date

02/14/2014

Expiration Date

03/31/2016

City

ELMWOOD PARK

State

Zip

60707

County

COOK

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/20/2016