TODD DAVID PEABODY OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****50

License Status

NOT RENEWED

Business

First Name

TODD

Middle

DAVID

Last Name

PEABODY

Suffix

Business Name

TODD DAVID PEABODY OD

Original Issue Date

06/27/2003

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

GREAT LAKES

State

Zip

60088

County

LAKE

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/18/2006