LORI ANN RICHARD OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047018859

License Status

NOT RENEWED

Business

First Name

LORI

Middle

ANN

Last Name

RICHARD

Suffix

Business Name

LORI ANN RICHARD OD

Original Issue Date

03/21/1996

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

PEKIN

State

Zip

61554

County

TAZEWELL

Ever Disciplined

LastModifiedDate

09/11/2005