MARTHA R TRIBBET OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930818

License Status

CANCELLED

Business

First Name

MARTHA

Middle

Last Name

TRIBBET

Suffix

Business Name

MARTHA R TRIBBET OD

Original Issue Date

01/05/2005

Effective Date

01/05/2005

Expiration Date

03/31/2006

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

09/01/2005