MICHAEL P BERT OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****83

License Status

NOT RENEWED

Business

First Name

MICHAEL P

Last Name

BERT

Suffix

Business Name

MICHAEL P BERT OD

Original Issue Date

08/28/1996

Effective Date

03/31/2022

Expiration Date

03/31/2024

City

WINCHESTER

State

Zip

22601

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

02/05/2025