KELLY A SANDERS 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

KELLY

Middle

Last Name

SANDERS

Suffix

Business Name

KELLY A SANDERS OD

Original Issue Date

10/20/2005

Effective Date

07/20/2020

Expiration Date

05/31/2022

City

MAHOMET

State

Zip

61853

County

CHAMPAIGN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

07/27/2022