EUGENE P ERTMAN OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****12

License Status

NOT RENEWED

Business

First Name

EUGENE

Middle

Last Name

ERTMAN

Suffix

Business Name

EUGENE P ERTMAN OD

Original Issue Date

10/08/2003

Effective Date

04/07/2010

Expiration Date

03/31/2012

City

LINCOLNWOOD

State

Zip

60712

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/16/2012