AGNES I ADU OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****87

License Status

NOT RENEWED

Business

First Name

AGNES I

Last Name

ADU

Suffix

Business Name

AGNES I ADU OD

Original Issue Date

06/04/1996

Expiration Date

03/31/1998

City

CHICAGO

State

Zip

60652

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/02/2005