VINCENT R FACCHIANO Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****63

License Status

NOT RENEWED

Business

First Name

VINCENT R

Last Name

FACCHIANO

Business Name

VINCENT R FACCHIANO

Original Issue Date

04/22/1996

Effective Date

01/10/2020

Expiration Date

05/31/2022

City

ROCKFORD

State

Zip

61112

County

WINNEBAGO

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

07/27/2022