JENNY BROOKE FERGUSON Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****19

License Status

NOT RENEWED

Business

First Name

JENNY

Middle

BROOKE

Last Name

FERGUSON

Business Name

JENNY BROOKE FERGUSON

Original Issue Date

06/22/2009

Effective Date

01/17/2014

Expiration Date

03/31/2016

City

CHICAGO

State

Zip

60607

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/20/2016