ALICJA JANINA FITZGERALD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****66

License Status

NOT RENEWED

Business

First Name

ALICJA

Middle

JANINA

Last Name

FITZGERALD

Business Name

ALICJA JANINA FITZGERALD

Original Issue Date

05/06/2016

Effective Date

05/06/2016

Expiration Date

03/31/2018

City

LOVES PARK

State

Zip

61111

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

06/19/2018