ALICE RENEE DAHL OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****95

License Status

NOT RENEWED

Business

Title

First Name

ALICE

Middle

RENEE

Last Name

DAHL

Business Name

ALICE RENEE DAHL OD

Original Issue Date

10/21/1999

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

VILLA PARK

State

Zip

60181

County

DUPAGE

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/18/2006