RICHARD N ROBERTS OD Optometrist License verification

Business Entity

INACTIVE

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****95

License Status

INACTIVE

Business

First Name

RICHARD

Middle

Last Name

ROBERTS

Suffix

Business Name

RICHARD N ROBERTS OD

Original Issue Date

12/02/1996

Effective Date

03/30/2010

Expiration Date

03/31/2012

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

01/12/2012