ROBERT DILLON FULLENWIDER Optometrist License verification

Business Entity

ACTIVE

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****48

License Status

ACTIVE

Business

First Name

ROBERT

Middle

DILLON

Last Name

FULLENWIDER

Business Name

ROBERT DILLON FULLENWIDER

Original Issue Date

06/08/2020

Effective Date

03/23/2026

Expiration Date

03/31/2028

City

SHILOH

State

Zip

62221

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/23/2026