SUSAN M PENNER OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047933293

License Status

CANCELLED

Business

First Name

SUSAN M

Last Name

PENNER

Suffix

Business Name

SUSAN M PENNER OD

Original Issue Date

08/13/2007

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

BYRON

State

Zip

61010

County

OGLE

Ever Disciplined

LastModifiedDate

05/04/2010