LORI ANN RICHARD OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****68

License Status

NOT RENEWED

Business

First Name

LORI

Middle

ANN

Last Name

RICHARD

Suffix

Business Name

LORI ANN RICHARD OD

Original Issue Date

09/16/2002

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

PEORIA

State

Zip

61614

County

PEORIA

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/18/2006