WANDA NGA-MAN LAM 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

WANDA

Middle

NGA-MAN

Last Name

LAM

Suffix

Business Name

WANDA NGA-MAN LAM OD

Original Issue Date

08/04/2003

Effective Date

03/25/2004

Expiration Date

03/31/2006

City

CHICAGO

State

Zip

60616

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/11/2006