DOUGLAS W DEVORE Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****08

License Status

NOT RENEWED

Business

First Name

DOUGLAS W

Last Name

DEVORE

Business Name

DOUGLAS W DEVORE

Original Issue Date

04/21/1997

Effective Date

01/04/2020

Expiration Date

05/31/2022

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

07/27/2022