ANETA GRITSAEV OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****95

License Status

NOT RENEWED

Business

Title

First Name

ANETA

Last Name

GRITSAEV

Business Name

ANETA GRITSAEV OD

Original Issue Date

08/13/2014

Effective Date

03/28/2016

Expiration Date

03/31/2018

City

ROCKFORD

State

Zip

61112

County

WINNEBAGO

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

06/19/2018