BRIAN W PECK OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****09

License Status

NOT RENEWED

Business

First Name

BRIAN W

Last Name

PECK

Suffix

Business Name

BRIAN W PECK OD

Original Issue Date

02/06/1997

Effective Date

01/18/2006

Expiration Date

03/31/2008

City

FULTON

State

Zip

61252

County

WHITESIDE

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/02/2008