SOL TANNEBAUM 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

SOL

Last Name

TANNEBAUM

Business Name

SOL TANNEBAUM

Original Issue Date

05/19/2000

Effective Date

01/25/2012

Expiration Date

03/31/2014

City

CALUMET CITY

State

Zip

60409

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/06/2014