LAURA J LONGNECKER Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****84

License Status

NOT RENEWED

Business

First Name

LAURA

Middle

Last Name

LONGNECKER

Business Name

LAURA J LONGNECKER

Original Issue Date

11/07/2011

Effective Date

11/07/2011

Expiration Date

03/31/2012

City

JERSEYVILLE

State

Zip

62052

County

JERSEY

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/16/2012