TIMOTHY J LEAHY OD Optometrist License verification

Business Entity

INACTIVE

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****12

License Status

INACTIVE

Business

First Name

TIMOTHY

Middle

Last Name

LEAHY

Suffix

Business Name

TIMOTHY J LEAHY OD

Original Issue Date

04/23/1997

Effective Date

03/16/2004

Expiration Date

03/31/2004

City

QUINCY

State

Zip

62301

County

ADAMS

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

01/18/2006