BARRY S BLATTBERG OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****20

License Status

NOT RENEWED

Business

Title

First Name

BARRY

Middle

Last Name

BLATTBERG

Business Name

BARRY S BLATTBERG OD

Original Issue Date

10/26/2001

Effective Date

03/18/2020

Expiration Date

05/31/2022

City

HILLSIDE

State

Zip

60162

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

07/27/2022