LAURA J PANKOW OD Optometrist License verification

Business Entity

INACTIVE

License Type

Optometrist

Description

LICENSED OPTOMETRIST

License Number

046008693

License Status

INACTIVE

Business

First Name

LAURA

Middle

Last Name

PANKOW

Suffix

Business Name

LAURA J PANKOW OD

Original Issue Date

12/01/1993

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

SOUTH BEND

State

Zip

46615

County

INDIANA

Ever Disciplined

LastModifiedDate

01/05/2010

Case Number

1996012128

Action

Fine

Discipline Start Date

07/31/1997

Discipline Reason

Failure to provide sufficient proof of required continuing education hours during a Department audit.