DIANE MARIE SLOTEMAKER OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****93

License Status

NOT RENEWED

Business

First Name

DIANE

Middle

MARIE

Last Name

SLOTEMAKER

Suffix

Business Name

DIANE MARIE SLOTEMAKER OD

Original Issue Date

11/17/1997

Effective Date

03/20/2009

Expiration Date

03/31/2010

City

CHICAGO

State

Zip

60614

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/04/2010