ROBERT L KIPPENBROCK 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

ROBERT

Middle

Last Name

KIPPENBROCK

Business Name

ROBERT L KIPPENBROCK OD

Original Issue Date

03/26/2002

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

CHESTER

State

Zip

62233

County

RANDOLPH

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/04/2010