ERICA DANIELLE BENNEHOFF OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047929908

License Status

NOT RENEWED

Business

Title

First Name

ERICA

Middle

DANIELLE

Last Name

BENNEHOFF

Business Name

ERICA DANIELLE BENNEHOFF OD

Original Issue Date

12/17/2003

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

KEWANEE

State

Zip

61443

County

HENRY

Ever Disciplined

LastModifiedDate

09/11/2005