ERICA DANIELLE BENNEHOFF OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930164

License Status

NOT RENEWED

Business

Title

First Name

ERICA

Middle

DANIELLE

Last Name

BENNEHOFF

Business Name

ERICA DANIELLE BENNEHOFF OD

Original Issue Date

05/26/2004

Effective Date

05/26/2004

Expiration Date

03/31/2006

City

PEORIA

State

Zip

61613

County

PEORIA

Ever Disciplined

LastModifiedDate

05/11/2006