PRAKSHA A BUTALA Optometrist License verification

Business Entity

ACTIVE

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****37

License Status

ACTIVE

Business

First Name

PRAKSHA

Middle

Last Name

BUTALA

Prefix

Business Name

PRAKSHA A BUTALA

Original Issue Date

05/26/2020

Effective Date

01/29/2024

Expiration Date

03/31/2026

City

ROCKFORD

State

Zip

61112

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/08/2026