TERRY G COOK Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****97

License Status

NOT RENEWED

Business

First Name

TERRY G

Last Name

COOK

Business Name

TERRY G COOK

Original Issue Date

06/13/1996

Effective Date

02/19/2008

Expiration Date

03/31/2010

City

MT VERNON

State

Zip

62864

County

JEFFERSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/04/2010