PRIYANKA PATEL Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****95

License Status

NOT RENEWED

Business

First Name

PRIYANKA

Last Name

PATEL

Prefix

Business Name

PRIYANKA PATEL

Original Issue Date

05/12/2021

Effective Date

05/12/2021

Expiration Date

05/31/2022

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022