ROBIN L CROCKER WILSON OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****32

License Status

NOT RENEWED

Business

First Name

ROBIN

Middle

L CROCKER

Last Name

WILSON

Suffix

Business Name

ROBIN L CROCKER WILSON OD

Original Issue Date

04/08/1996

Effective Date

03/24/2016

Expiration Date

03/31/2018

City

PEORIA

State

Zip

61615

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

06/19/2018