LARRY G BROKERING OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047926098

License Status

NOT RENEWED

Business

First Name

LARRY

Middle

Last Name

BROKERING

Suffix

Business Name

LARRY G BROKERING OD

Original Issue Date

01/15/1999

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

BELLEVILLE

State

Zip

62226

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

09/11/2005