JEFFREY EDWIN MONTGOMERY Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047927862

License Status

NOT RENEWED

Business

First Name

JEFFREY

Middle

EDWIN

Last Name

MONTGOMERY

Business Name

JEFFREY EDWIN MONTGOMERY

Original Issue Date

05/04/2001

Effective Date

03/09/2004

Expiration Date

03/31/2006

City

PEKIN

State

Zip

61554

County

TAZEWELL

Ever Disciplined

LastModifiedDate

05/11/2006