DAVID JOHN ANDERSON 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

JOHN

Last Name

ANDERSON

Suffix

Business Name

DAVID JOHN ANDERSON OD

Original Issue Date

12/28/1999

Effective Date

03/25/2016

Expiration Date

03/31/2018

City

FREEPORT

State

Zip

61034

County

STEPHENSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

06/19/2018