NATHAN E GOLDBERG OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****18

License Status

NOT RENEWED

Business

First Name

NATHAN

Middle

Last Name

GOLDBERG

Suffix

Business Name

NATHAN E GOLDBERG OD

Original Issue Date

06/04/2012

Effective Date

02/14/2018

Expiration Date

09/30/2020

City

BUFFALO GROVE

State

Zip

60089

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

01/14/2021