E D ATTAYA OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****82

License Status

NOT RENEWED

Business

First Name

Middle

Last Name

ATTAYA

Suffix

Business Name

E D ATTAYA OD

Original Issue Date

06/04/1996

Effective Date

01/25/2012

Expiration Date

03/31/2014

City

CHICAGO

State

Zip

60608

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/06/2014