JEREMY D KEITH Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****11

License Status

NOT RENEWED

Business

First Name

JEREMY

Middle

Last Name

KEITH

Business Name

JEREMY D KEITH

Original Issue Date

06/30/2010

Effective Date

02/03/2012

Expiration Date

03/31/2014

City

FORSYTH

State

Zip

62535

County

MACON

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/06/2014