LARRY G BROKERING OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****15

License Status

NOT RENEWED

Business

First Name

LARRY

Middle

Last Name

BROKERING

Suffix

Business Name

LARRY G BROKERING OD

Original Issue Date

06/13/1996

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

BELLEVILLE

State

Zip

62221

County

SAINT CLAIR

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/04/2010