MARK B BUSCH OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****13

License Status

NOT RENEWED

Business

First Name

MARK

Middle

Last Name

BUSCH

Suffix

Business Name

MARK B BUSCH OD

Original Issue Date

05/29/2002

Effective Date

04/03/2018

Expiration Date

09/30/2020

City

HOFFMAN ESTATES

State

Zip

60169

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/14/2021