ERIK D BURGWALD OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047028644

License Status

NOT RENEWED

Business

First Name

ERIK D

Last Name

BURGWALD

Suffix

Business Name

ERIK D BURGWALD OD

Original Issue Date

03/10/1995

Expiration Date

03/31/1998

City

STERLING

State

Zip

61081

County

WHITESIDE

Ever Disciplined

LastModifiedDate

09/01/2005