KELLEY SCHWARTE BAUMHOVER OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****31

License Status

NOT RENEWED

Business

First Name

KELLEY

Middle

SCHWARTE

Last Name

BAUMHOVER

Suffix

Business Name

KELLEY SCHWARTE BAUMHOVER OD

Original Issue Date

09/13/2004

Effective Date

03/30/2010

Expiration Date

03/31/2012

City

QUINCY

State

Zip

62301

County

ADAMS

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/16/2012