ERIK D BURGWALD OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047925807

License Status

NOT RENEWED

Business

First Name

ERIK D

Last Name

BURGWALD

Suffix

Business Name

ERIK D BURGWALD OD

Original Issue Date

08/18/1998

Effective Date

05/18/2000

Expiration Date

03/31/2000

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Ever Disciplined

LastModifiedDate

09/11/2005