ELLYN RACHEL KOZOB LERNER OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****84

License Status

NOT RENEWED

Business

Title

First Name

ELLYN

Middle

RACHEL

Last Name

KOZOB LERNER

Business Name

ELLYN RACHEL KOZOB LERNER OD

Original Issue Date

09/09/2013

Effective Date

01/24/2018

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60613

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III

Ever Disciplined

LastModifiedDate

01/14/2021