EDWARD E PERRY OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****55

License Status

NOT RENEWED

Business

Title

First Name

EDWARD

Middle

Last Name

PERRY

Business Name

EDWARD E PERRY OD

Original Issue Date

05/30/1996

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

CENTRALIA

State

Zip

62801

County

MARION

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/18/2006