DANIEL A WOLF OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****16

License Status

NOT RENEWED

Business

First Name

DANIEL

Middle

Last Name

WOLF

Suffix

Business Name

DANIEL A WOLF OD

Original Issue Date

04/06/2001

Effective Date

01/04/2020

Expiration Date

05/31/2022

City

CENTRALIA

State

Zip

62801

County

MARION

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022