ANJU MATHEW KANIKUNNEL OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****86

License Status

NOT RENEWED

Business

Title

First Name

ANJU

Middle

MATHEW

Last Name

KANIKUNNEL

Business Name

ANJU MATHEW KANIKUNNEL OD

Original Issue Date

09/18/2013

Effective Date

02/26/2014

Expiration Date

03/31/2016

City

PEORIA

State

Zip

61614

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/20/2016