BENNA K DAUGHERTY Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****54

License Status

NOT RENEWED

Business

First Name

BENNA K

Last Name

DAUGHERTY

Business Name

BENNA K DAUGHERTY

Original Issue Date

04/15/1996

Effective Date

03/12/2022

Expiration Date

03/31/2024

City

HARRISBURG

State

Zip

62946

County

SALINE

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

02/05/2025