CHAD R SLAGLE OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****77

License Status

NOT RENEWED

Business

Title

First Name

CHAD

Middle

Last Name

SLAGLE

Business Name

CHAD R SLAGLE OD

Original Issue Date

08/28/2013

Effective Date

03/10/2016

Expiration Date

03/31/2018

City

LOVES PARK

State

Zip

61111

County

WINNEBAGO

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

06/19/2018