JEFFREY R HENLINE OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047057713

License Status

CANCELLED

Business

First Name

JEFFREY

Middle

Last Name

HENLINE

Suffix

Business Name

JEFFREY R HENLINE OD

Original Issue Date

11/14/1996

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

GALESBURG

State

Zip

61401

County

KNOX

Ever Disciplined

LastModifiedDate

05/04/2010