MARY BETH RHOMBERG OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****11

License Status

CANCELLED

Business

First Name

MARY

Middle

BETH

Last Name

RHOMBERG

Suffix

Business Name

MARY BETH RHOMBERG OD

Original Issue Date

08/22/2007

Effective Date

08/22/2007

Expiration Date

03/31/2008

City

COLLINSVILLE

State

Zip

62234

County

MADISON

Specialty/Qualifier

HOSPITAL/CLINIC

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

01/10/2008