HEATHER MARIE COCKLAN Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047929642

License Status

NOT RENEWED

Business

First Name

HEATHER

Middle

MARIE

Last Name

COCKLAN

Business Name

HEATHER MARIE COCKLAN

Original Issue Date

08/25/2003

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

ROCKFORD

State

Zip

61112

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

09/11/2005