MARCUS J NEITZKE OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****46

License Status

NOT RENEWED

Business

First Name

MARCUS

Middle

Last Name

NEITZKE

Suffix

Business Name

MARCUS J NEITZKE OD

Original Issue Date

10/21/2004

Effective Date

10/21/2004

Expiration Date

03/31/2006

City

WESTCHESTER

State

Zip

60154

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/11/2006