ALLEN M PULLIAM Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****06

License Status

NOT RENEWED

Business

First Name

ALLEN M

Last Name

PULLIAM

Business Name

ALLEN M PULLIAM

Original Issue Date

10/18/2005

Effective Date

01/18/2006

Expiration Date

03/31/2008

City

QUINCY

State

Zip

62301

County

ADAMS

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/02/2008