ADAM P WIRA OD - Optometrist License in Missouri | # 34*****17

ADAM P WIRA OD

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****17

License Status

NOT RENEWED

Business

N

Title

OD

First Name

ADAM

Middle

P

Last Name

WIRA

Business Name

ADAM P WIRA OD

Original Issue Date

11/27/2019

Effective Date

11/27/2019

Expiration Date

09/30/2020

State

MO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

V

Ever Disciplined

N

LastModifiedDate

01/14/2021