GARY T KOTELES OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****75

License Status

NOT RENEWED

Business

First Name

GARY

Middle

Last Name

KOTELES

Suffix

Business Name

GARY T KOTELES OD

Original Issue Date

11/06/1997

Effective Date

02/15/2018

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

01/14/2021