DENNIS EARL DETTMANN OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047931521

License Status

CANCELLED

Business

Title

First Name

DENNIS

Middle

EARL

Last Name

DETTMANN

Business Name

DENNIS EARL DETTMANN OD

Original Issue Date

09/30/2005

Effective Date

02/19/2008

Expiration Date

03/31/2010

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/04/2010