MIRIAM M WELLER 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

MIRIAM

Middle

Last Name

WELLER

Business Name

MIRIAM M WELLER

Original Issue Date

01/30/2007

Effective Date

01/30/2020

Expiration Date

05/31/2022

City

GLENVIEW

State

Zip

60026

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

07/27/2022