ERIK D BURGWALD OD Optometrist License verification

Business Entity

ACTIVE

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****84

License Status

ACTIVE

Business

First Name

ERIK D

Last Name

BURGWALD

Suffix

Business Name

ERIK D BURGWALD OD

Original Issue Date

04/08/1997

Effective Date

03/28/2024

Expiration Date

03/31/2026

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

01/08/2026