KEITH THOMAS HEDRICK Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****10

License Status

NOT RENEWED

Business

First Name

KEITH THOMAS

Last Name

HEDRICK

Business Name

KEITH THOMAS HEDRICK

Original Issue Date

06/04/1996

Effective Date

03/04/2014

Expiration Date

03/31/2016

City

CARLINVILLE

State

Zip

62626

County

MACOUPIN

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/20/2016