ROBERT L KIPPENBROCK OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****84

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

01/10/2008

Expiration Date

03/31/2010

City

CARBONDALE

State

Zip

62901

County

JACKSON

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/04/2010