LUCIANA MARIE PETITTI OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****66

License Status

NOT RENEWED

Business

Title

First Name

LUCIANA

Middle

MARIE

Last Name

PETITTI

Business Name

LUCIANA MARIE PETITTI OD

Original Issue Date

06/26/2018

Effective Date

06/26/2018

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60622

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021