KURT JACOB BENNETT OD - Optometrist License in Illinois | # 34*****02

KURT JACOB BENNETT OD

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****02

License Status

NOT RENEWED

Business

N

Title

OD

First Name

KURT

Middle

JACOB

Last Name

BENNETT

Business Name

KURT JACOB BENNETT OD

Original Issue Date

10/15/2013

Effective Date

10/15/2013

Expiration Date

03/31/2014

State

IL

Specialty/Qualifier

PHARM DISTRIBUTOR

Controlled Substance Schedule

III

Ever Disciplined

N

LastModifiedDate

05/06/2014