JOANNA BOMKAMP GEBHARDT Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****16

License Status

NOT RENEWED

Business

First Name

JOANNA

Middle

BOMKAMP

Last Name

GEBHARDT

Business Name

JOANNA BOMKAMP GEBHARDT

Original Issue Date

05/10/2012

Effective Date

01/31/2014

Expiration Date

03/31/2016

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/20/2016