DUANE L FONTANA Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****57

License Status

NOT RENEWED

Business

First Name

DUANE L

Last Name

FONTANA

Business Name

DUANE L FONTANA

Original Issue Date

05/07/1996

Effective Date

03/01/2016

Expiration Date

03/31/2018

City

BUFFALO GROVE

State

Zip

60089

County

LAKE

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

06/19/2018