DIRK F MASSIE OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****18

License Status

NOT RENEWED

Business

First Name

DIRK

Middle

Last Name

MASSIE

Suffix

Business Name

DIRK F MASSIE OD

Original Issue Date

10/19/2001

Effective Date

03/29/2018

Expiration Date

09/30/2020

City

SWANSEA

State

Zip

62226

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/14/2021