MICHELLE LYNN SALL OD Optometrist License verification

Business Entity

INACTIVE

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****92

License Status

INACTIVE

Business

First Name

MICHELLE

Middle

LYNN

Last Name

SALL

Suffix

Business Name

MICHELLE LYNN SALL OD

Original Issue Date

05/24/2011

Effective Date

02/06/2012

Expiration Date

03/31/2014

City

LAKE VILLE

State

Zip

60046

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

01/09/2014