TODD E FUNK OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047928382

License Status

NOT RENEWED

Business

First Name

TODD E

Last Name

FUNK

Suffix

Business Name

TODD E FUNK OD

Original Issue Date

01/28/2002

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

EAST PEORIA

State

Zip

61611

County

TAZEWELL

Ever Disciplined

LastModifiedDate

09/11/2005