PATRICK M NIEBRUGGE Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****02

License Status

NOT RENEWED

Business

First Name

PATRICK M

Last Name

NIEBRUGGE

Business Name

PATRICK M NIEBRUGGE

Original Issue Date

05/21/1996

Effective Date

05/14/2022

Expiration Date

03/31/2024

City

CASEY

State

Zip

62420

County

CLARK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

02/05/2025