KERRY H HEAD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****93

License Status

NOT RENEWED

Business

First Name

KERRY

Middle

Last Name

HEAD

Business Name

KERRY H HEAD

Original Issue Date

10/14/1999

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

EAST PEORIA

State

Zip

61611

County

TAZEWELL

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/18/2006