TODD ROBERT WOLLBRINCK Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****72

License Status

NOT RENEWED

Business

First Name

TODD

Middle

ROBERT

Last Name

WOLLBRINCK

Business Name

TODD ROBERT WOLLBRINCK

Original Issue Date

09/20/2002

Effective Date

02/24/2009

Expiration Date

03/31/2010

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/04/2010