LANE DONALD RUPPE Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****63

License Status

NOT RENEWED

Business

First Name

LANE DONALD

Last Name

RUPPE

Business Name

LANE DONALD RUPPE

Original Issue Date

10/13/2000

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/11/2005