NICOLE SUZANNE HANISH OD Optometrist License verification

Business Entity

ACTIVE

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****01

License Status

ACTIVE

Business

Title

First Name

NICOLE

Middle

SUZANNE

Last Name

HANISH

Business Name

NICOLE SUZANNE HANISH OD

Original Issue Date

08/31/2019

Effective Date

03/04/2026

Expiration Date

03/31/2028

City

FAIRFIELD

State

Zip

62837

County

WAYNE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/04/2026