KERRY H HEAD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047929704

License Status

NOT RENEWED

Business

First Name

KERRY

Middle

Last Name

HEAD

Business Name

KERRY H HEAD

Original Issue Date

09/23/2003

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

PEORIA

State

Zip

61604

County

PEORIA

Ever Disciplined

LastModifiedDate

09/11/2005