BRIAN K ORTIZ OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****52

License Status

NOT RENEWED

Business

First Name

BRIAN

Middle

Last Name

ORTIZ

Suffix

Business Name

BRIAN K ORTIZ OD

Original Issue Date

05/30/1997

Effective Date

04/02/2018

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60602

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/14/2021