SIJIA S NOTH OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****10

License Status

NOT RENEWED

Business

First Name

SIJIA

Middle

Last Name

NOTH

Suffix

Business Name

SIJIA S NOTH OD

Original Issue Date

06/10/2005

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

FORSYTH

State

Zip

62535

County

MACON

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/04/2010