KRISTOPHER LEE GLANVILLE Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****74

License Status

NOT RENEWED

Business

First Name

KRISTOPHER

Middle

LEE

Last Name

GLANVILLE

Business Name

KRISTOPHER LEE GLANVILLE

Original Issue Date

11/25/2008

Effective Date

11/25/2008

Expiration Date

03/31/2010

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/04/2010