LEO J PRENTICE Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****81

License Status

NOT RENEWED

Business

First Name

LEO J

Last Name

PRENTICE

Business Name

LEO J PRENTICE

Original Issue Date

09/16/1996

Effective Date

03/21/2016

Expiration Date

03/31/2018

City

WOODRIDGE

State

Zip

60517

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/19/2018