ERNEST I WATANABE Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****71

License Status

NOT RENEWED

Business

First Name

ERNEST I

Last Name

WATANABE

Business Name

ERNEST I WATANABE

Original Issue Date

04/22/1996

Effective Date

04/03/2018

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60660

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

01/14/2021