MATTHEW W GIFFORD OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****11

License Status

NOT RENEWED

Business

First Name

MATTHEW

Middle

Last Name

GIFFORD

Suffix

Business Name

MATTHEW W GIFFORD OD

Original Issue Date

10/08/2003

Effective Date

03/22/2018

Expiration Date

09/30/2020

City

OAK PARK

State

Zip

60301

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/14/2021