AMY JOANNE KNICKERBOCKER OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****39

License Status

NOT RENEWED

Business

First Name

AMY

Middle

JOANNE

Last Name

KNICKERBOCKER

Suffix

Business Name

AMY JOANNE KNICKERBOCKER OD

Original Issue Date

12/06/2001

Effective Date

01/25/2012

Expiration Date

03/31/2014

City

PITTSFIELD

State

Zip

62363

County

PIKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/06/2014