E DALE BROCK Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST

License Number

046006814

License Status

NOT RENEWED

Business

First Name

E DALE

Last Name

BROCK

Business Name

E DALE BROCK

Original Issue Date

07/15/1976

Effective Date

01/22/2018

Expiration Date

09/30/2020

City

WEST FRANKFORT

State

Zip

62896

County

FRANKLIN

Ever Disciplined

LastModifiedDate

01/14/2021