JILL SUZANNE DAVIDS OD - Optometrist License in Indiana | # 34*****86

JILL SUZANNE DAVIDS OD

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****86

License Status

NOT RENEWED

Business

N

First Name

JILL

Middle

SUZANNE

Last Name

DAVIDS

Suffix

OD

Business Name

JILL SUZANNE DAVIDS OD

Original Issue Date

06/23/2004

Effective Date

01/04/2020

Expiration Date

05/31/2022

State

IN

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

N

LastModifiedDate

07/27/2022