JEFFREY EDWIN MONTGOMERY Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047927899

License Status

NOT RENEWED

Business

First Name

JEFFREY

Middle

EDWIN

Last Name

MONTGOMERY

Business Name

JEFFREY EDWIN MONTGOMERY

Original Issue Date

05/15/2001

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

PEORIA

State

Zip

61614

County

PEORIA

Ever Disciplined

LastModifiedDate

09/11/2005