AMBER LEAH MCCORMICK-GOSSAGE OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****23

License Status

NOT RENEWED

Business

First Name

AMBER

Middle

LEAH

Last Name

MCCORMICK-GOSSAGE

Suffix

Business Name

AMBER LEAH MCCORMICK-GOSSAGE OD

Original Issue Date

04/25/2007

Effective Date

04/25/2007

Expiration Date

03/31/2008

City

CHESTER

State

Zip

62233

County

RANDOLPH

Specialty/Qualifier

HOSPITAL/CLINIC

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/02/2008