DENNIS M BRTVA Optometrist License verification

Business Entity

ACTIVE

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****04

License Status

ACTIVE

Business

First Name

DENNIS M

Last Name

BRTVA

Business Name

DENNIS M BRTVA

Original Issue Date

11/19/1996

Effective Date

03/01/2026

Expiration Date

03/31/2028

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

03/01/2026