JACKSON R BENNETT JR OD Optometrist License verification

Business Entity

ACTIVE

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****14

License Status

ACTIVE

Business

First Name

JACKSON

Middle

Last Name

BENNETT

Suffix

JR OD

Business Name

JACKSON R BENNETT JR OD

Original Issue Date

11/19/1996

Effective Date

03/14/2026

Expiration Date

03/31/2028

City

PEORIA

State

Zip

61614

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

03/14/2026