ADAM J OTTAVIANO Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****91

License Status

NOT RENEWED

Business

First Name

ADAM

Middle

Last Name

OTTAVIANO

Business Name

ADAM J OTTAVIANO

Original Issue Date

06/28/2010

Effective Date

03/22/2018

Expiration Date

09/30/2020

City

MUNDELEIN

State

Zip

60060

County

LAKE

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

01/14/2021