MARIANNE E BOLTZ OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****03

License Status

NOT RENEWED

Business

First Name

MARIANNE E

Last Name

BOLTZ

Suffix

Business Name

MARIANNE E BOLTZ OD

Original Issue Date

01/13/1997

Expiration Date

03/31/1998

City

CHICAGO

State

Zip

60616

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/02/2005