GLENN DONALD KUELTZO Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****38

License Status

NOT RENEWED

Business

First Name

GLENN DONALD

Last Name

KUELTZO

Business Name

GLENN DONALD KUELTZO

Original Issue Date

10/09/1996

Effective Date

05/18/2000

Expiration Date

03/31/2000

City

FOREST PARK

State

Zip

60130

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/18/2006