KELLY TRUONG Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****95

License Status

NOT RENEWED

Business

First Name

KELLY

Last Name

TRUONG

Business Name

KELLY TRUONG

Original Issue Date

08/04/2008

Effective Date

08/04/2008

Expiration Date

03/31/2010

City

CHICAGO

State

Zip

60602

County

COOK

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/04/2010