LISANNE CLOSE OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****80

License Status

NOT RENEWED

Business

First Name

LISANNE

Last Name

Suffix

Business Name

LISANNE CLOSE OD

Original Issue Date

05/30/1996

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

LINCOLNWOOD

State

Zip

60712

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/18/2006