DEREK BRYAN HENNIG OD Optometrist License verification

Business Entity

ACTIVE

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****60

License Status

ACTIVE

Business

Title

First Name

DEREK

Middle

BRYAN

Last Name

HENNIG

Business Name

DEREK BRYAN HENNIG OD

Original Issue Date

05/25/2017

Effective Date

03/05/2026

Expiration Date

03/31/2028

City

CHARLESTON

State

Zip

61920

County

COLES

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/05/2026