BETSY LYNN FUNK OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****69

License Status

NOT RENEWED

Business

First Name

BETSY

Middle

LYNN

Last Name

FUNK

Suffix

Business Name

BETSY LYNN FUNK OD

Original Issue Date

08/27/2001

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/11/2005