KELSEY LAUREN FREDERICK OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****98

License Status

NOT RENEWED

Business

Title

First Name

KELSEY

Middle

LAUREN

Last Name

FREDERICK

Business Name

KELSEY LAUREN FREDERICK OD

Original Issue Date

08/18/2014

Effective Date

04/01/2022

Expiration Date

03/31/2024

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

02/05/2025