DONALD W CRUDEN OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****67

License Status

NOT RENEWED

Business

First Name

DONALD

Middle

Last Name

CRUDEN

Suffix

Business Name

DONALD W CRUDEN OD

Original Issue Date

05/09/1996

Effective Date

01/05/2010

Expiration Date

03/31/2012

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/16/2012