EMILY ANNE SMITH OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****06

License Status

NOT RENEWED

Business

First Name

EMILY

Middle

ANNE

Last Name

SMITH

Suffix

Business Name

EMILY ANNE SMITH OD

Original Issue Date

08/14/2007

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

DU QUOIN

State

Zip

62832

County

PERRY

Specialty/Qualifier

HOSPITAL/CLINIC

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/04/2010