LYNNE C STANFORD OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****96

License Status

NOT RENEWED

Business

First Name

LYNNE

Middle

Last Name

STANFORD

Suffix

Business Name

LYNNE C STANFORD OD

Original Issue Date

04/05/2002

Effective Date

03/08/2012

Expiration Date

03/31/2014

City

DEERFIELD

State

Zip

60015

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/06/2014