PATRICK M NIEBRUGGE Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047007315

License Status

CANCELLED

Business

First Name

PATRICK M

Last Name

NIEBRUGGE

Business Name

PATRICK M NIEBRUGGE

Original Issue Date

06/05/1990

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

DIETERICH

State

Zip

62424

County

EFFINGHAM

Ever Disciplined

LastModifiedDate

05/04/2010