MARTHA R TRIBBET OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****41

License Status

NOT RENEWED

Business

First Name

MARTHA

Middle

Last Name

TRIBBET

Suffix

Business Name

MARTHA R TRIBBET OD

Original Issue Date

04/04/1997

Effective Date

04/12/2010

Expiration Date

03/31/2012

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/16/2012