ROBERT L KIPPENBROCK OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****83

License Status

NOT RENEWED

Business

Title

First Name

ROBERT

Middle

Last Name

KIPPENBROCK

Business Name

ROBERT L KIPPENBROCK OD

Original Issue Date

11/29/2000

Effective Date

02/24/2004

Expiration Date

03/31/2006

City

CARTERVILLE

State

Zip

62918

County

WILLIAMSON

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/11/2006