KURT KENNETH NELSON Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****08

License Status

NOT RENEWED

Business

First Name

KURT KENNETH

Last Name

NELSON

Business Name

KURT KENNETH NELSON

Original Issue Date

09/06/1996

Effective Date

03/08/2018

Expiration Date

09/30/2020

City

DIXON

State

Zip

61021

County

LEE

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

01/14/2021