EZRA ATIKUNE OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****99

License Status

NOT RENEWED

Business

First Name

EZRA

Last Name

ATIKUNE

Suffix

Business Name

EZRA ATIKUNE OD

Original Issue Date

06/28/2004

Effective Date

01/05/2010

Expiration Date

03/31/2012

City

CHICAGO

State

Zip

60622

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/16/2012