ERIK D BURGWALD OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****67

License Status

NOT RENEWED

Business

First Name

ERIK D

Last Name

BURGWALD

Suffix

Business Name

ERIK D BURGWALD OD

Original Issue Date

01/10/1997

Expiration Date

03/31/1998

City

SYCAMORE

State

Zip

60178

County

DEKALB

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/18/2006