HENRY R MOORE OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****78

License Status

NOT RENEWED

Business

Title

First Name

HENRY

Middle

Last Name

MOORE

Business Name

HENRY R MOORE OD

Original Issue Date

12/05/2007

Effective Date

03/17/2010

Expiration Date

03/31/2012

City

CHICAGO

State

Zip

60609

County

COOK

Specialty/Qualifier

HOSPITAL/CLINIC

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/16/2012