DAVID A MAZE OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****24

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

Last Name

MAZE

Suffix

Business Name

DAVID A MAZE OD

Original Issue Date

08/20/2004

Effective Date

03/16/2020

Expiration Date

05/31/2022

City

WESTMONT

State

Zip

60559

County

DUPAGE

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022