GARY R CROSBY 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

GARY R

Last Name

CROSBY

Business Name

GARY R CROSBY

Original Issue Date

07/29/1996

Effective Date

03/03/2014

Expiration Date

03/31/2016

City

MACOMB

State

Zip

61455

County

MCDONOUGH

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/20/2016