KERRY H HEAD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****96

License Status

NOT RENEWED

Business

First Name

KERRY

Middle

Last Name

HEAD

Business Name

KERRY H HEAD

Original Issue Date

11/19/1996

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

PEORIA

State

Zip

61614

County

PEORIA

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/18/2006