ROBERT E SMITH 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

ROBERT E

Last Name

SMITH

Suffix

Business Name

ROBERT E SMITH OD

Original Issue Date

12/09/1999

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

ALTON

State

Zip

62002

County

MADISON

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/11/2005