BRIAN W PECK OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047929869

License Status

NOT RENEWED

Business

First Name

BRIAN W

Last Name

PECK

Suffix

Business Name

BRIAN W PECK OD

Original Issue Date

12/01/2003

Effective Date

04/02/2004

Expiration Date

03/31/2006

City

SAVANNA

State

Zip

61074

County

CARROLL

Ever Disciplined

LastModifiedDate

05/11/2006