DAVID T HICKS Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****04

License Status

NOT RENEWED

Business

First Name

DAVID T

Last Name

HICKS

Business Name

DAVID T HICKS

Original Issue Date

09/24/2003

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

JOLIET

State

Zip

60435

County

WILL

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/18/2006