JASON STUART PFEIFER OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****56

License Status

NOT RENEWED

Business

First Name

JASON

Middle

STUART

Last Name

PFEIFER

Suffix

Business Name

JASON STUART PFEIFER OD

Original Issue Date

10/10/2000

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

ROCKFORD

State

Zip

61112

County

WINNEBAGO

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/11/2005