JEFFREY EDWIN MONTGOMERY Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047925500

License Status

CANCELLED

Business

First Name

JEFFREY

Middle

EDWIN

Last Name

MONTGOMERY

Business Name

JEFFREY EDWIN MONTGOMERY

Original Issue Date

11/12/1997

Effective Date

05/30/2001

Expiration Date

03/31/2002

City

EAST PEORIA

State

Zip

61602

County

PEORIA

Ever Disciplined

LastModifiedDate

09/01/2005