JANNA F BROCKMAN OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****97

License Status

NOT RENEWED

Business

Title

First Name

JANNA

Middle

Last Name

BROCKMAN

Business Name

JANNA F BROCKMAN OD

Original Issue Date

07/30/2007

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

DANVILLE

State

Zip

61832

County

VERMILION

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/04/2010