RACHANA S PATEL CARRIZALES Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****92

License Status

NOT RENEWED

Business

First Name

RACHANA

Middle

Last Name

PATEL CARRIZALES

Business Name

RACHANA S PATEL CARRIZALES

Original Issue Date

07/17/2007

Effective Date

02/19/2010

Expiration Date

03/31/2012

City

PEORIA

State

Zip

61615

County

PEORIA

Specialty/Qualifier

HOSPITAL/CLINIC

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/16/2012