NISHA B JANI-KONDURI 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

NISHA

Middle

Last Name

JANI-KONDURI

Business Name

NISHA B JANI-KONDURI

Original Issue Date

05/18/2000

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

ORLAND PARK

State

Zip

60462

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/18/2006