JESSE JACOB FERTIG OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****45

License Status

NOT RENEWED

Business

First Name

JESSE

Middle

JACOB

Last Name

FERTIG

Suffix

Business Name

JESSE JACOB FERTIG OD

Original Issue Date

12/29/2003

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

CHICAGO

State

Zip

60610

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/04/2010