CHARLES N BERTOIA OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****65

License Status

NOT RENEWED

Business

Title

First Name

CHARLES

Middle

Last Name

BERTOIA

Business Name

CHARLES N BERTOIA OD

Original Issue Date

10/18/2000

Effective Date

04/02/2004

Expiration Date

03/31/2006

City

CHICAGO

State

Zip

60603

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/11/2006