ERICA DANIELLE BENNEHOFF OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****67

License Status

NOT RENEWED

Business

Title

First Name

ERICA

Middle

DANIELLE

Last Name

BENNEHOFF

Business Name

ERICA DANIELLE BENNEHOFF OD

Original Issue Date

04/12/2004

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

HILLSBORO

State

Zip

62049

County

MONTGOMERY

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/04/2010