CARLA ANN URSETTA OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****11

License Status

NOT RENEWED

Business

Title

First Name

CARLA

Middle

ANN

Last Name

URSETTA

Business Name

CARLA ANN URSETTA OD

Original Issue Date

08/12/2008

Effective Date

08/12/2008

Expiration Date

03/31/2010

City

BERWYN

State

Zip

60402

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/04/2010