MATTHEW PIETZ LARSON OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****03

License Status

NOT RENEWED

Business

Title

First Name

MATTHEW

Middle

PIETZ

Last Name

LARSON

Business Name

MATTHEW PIETZ LARSON OD

Original Issue Date

08/13/2015

Effective Date

03/14/2018

Expiration Date

09/30/2020

City

DOWNERS GROVE

State

Zip

60515

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021