MICHAEL ANGELO BERTUCCI OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****48

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

ANGELO

Last Name

BERTUCCI

Suffix

Business Name

MICHAEL ANGELO BERTUCCI OD

Original Issue Date

03/23/2010

Effective Date

03/23/2010

Expiration Date

03/31/2012

City

OSWEGO

State

Zip

60543

County

KENDALL

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/16/2012