LISA B DIBLER OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047028649

License Status

NOT RENEWED

Business

First Name

LISA

Middle

Last Name

DIBLER

Suffix

Business Name

LISA B DIBLER OD

Original Issue Date

03/21/1996

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

EAST ST LOUIS

State

Zip

62201

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

09/11/2005