ERIK JAMES MOTHERSBAUGH 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

ERIK

Middle

JAMES

Last Name

MOTHERSBAUGH

Business Name

ERIK JAMES MOTHERSBAUGH OD

Original Issue Date

06/04/2012

Effective Date

03/19/2018

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60616

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

01/14/2021