DOUGLAS W DEVORE Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****13

License Status

NOT RENEWED

Business

First Name

DOUGLAS W

Last Name

DEVORE

Business Name

DOUGLAS W DEVORE

Original Issue Date

01/29/2003

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/18/2006