MICHAEL S FELDT Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****96

License Status

NOT RENEWED

Business

First Name

MICHAEL S

Last Name

FELDT

Business Name

MICHAEL S FELDT

Original Issue Date

04/22/1996

Effective Date

03/19/2014

Expiration Date

03/31/2016

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/20/2016