MAGDALENA LUCIA BAK OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****89

License Status

NOT RENEWED

Business

First Name

MAGDALENA

Middle

LUCIA

Last Name

BAK

Suffix

Business Name

MAGDALENA LUCIA BAK OD

Original Issue Date

06/28/2010

Effective Date

06/20/2018

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60602

County

COOK

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

01/14/2021