MICHAEL ANGELO BERTUCCI OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****78

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

ANGELO

Last Name

BERTUCCI

Suffix

Business Name

MICHAEL ANGELO BERTUCCI OD

Original Issue Date

03/10/2005

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

CHICAGO

State

Zip

60622

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/04/2010