LYNN A WOLLENBERG OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047934631

License Status

CANCELLED

Business

First Name

LYNN

Middle

Last Name

WOLLENBERG

Suffix

Business Name

LYNN A WOLLENBERG OD

Original Issue Date

09/10/2008

Effective Date

09/10/2008

Expiration Date

03/31/2010

City

CLINTON

State

Zip

61727

County

DE WITT

Ever Disciplined

LastModifiedDate

05/04/2010