JEROME C LIETZ Optometrist License verification

Business Entity

ACTIVE

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****36

License Status

ACTIVE

Business

First Name

JEROME C

Last Name

LIETZ

Business Name

JEROME C LIETZ

Original Issue Date

02/02/2000

Effective Date

03/14/2024

Expiration Date

03/31/2026

City

CREST HILL

State

Zip

60403

County

WILL

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

01/08/2026