KENT MICHAEL DAUM OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****97

License Status

NOT RENEWED

Business

Title

First Name

KENT

Middle

MICHAEL

Last Name

DAUM

Business Name

KENT MICHAEL DAUM OD

Original Issue Date

03/02/2009

Effective Date

02/25/2010

Expiration Date

03/31/2012

City

CHICAGO

State

Zip

60616

County

COOK

Specialty/Qualifier

TEACHING INSTITUTION

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/16/2012