UTANG EDET EKPO OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****19

License Status

NOT RENEWED

Business

Title

First Name

UTANG

Middle

EDET

Last Name

EKPO

Business Name

UTANG EDET EKPO OD

Original Issue Date

07/19/2016

Effective Date

01/04/2020

Expiration Date

05/31/2022

City

DANVILLE

State

Zip

61832

County

VERMILION

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022