MAX ROSE OD 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

MAX

Last Name

ROSE

Suffix

Business Name

MAX ROSE OD

Original Issue Date

08/20/1996

Effective Date

03/15/2018

Expiration Date

09/30/2020

City

VERNON HILLS

State

Zip

60061

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

01/14/2021