JEFFREY EDWIN MONTGOMERY Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930882

License Status

CANCELLED

Business

First Name

JEFFREY

Middle

EDWIN

Last Name

MONTGOMERY

Business Name

JEFFREY EDWIN MONTGOMERY

Original Issue Date

02/08/2005

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

LINCOLN

State

Zip

62656

County

LOGAN

Ever Disciplined

LastModifiedDate

05/04/2010