ANTHONY JOSEPH SMITH OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****26

License Status

NOT RENEWED

Business

First Name

ANTHONY

Middle

JOSEPH

Last Name

SMITH

Suffix

Business Name

ANTHONY JOSEPH SMITH OD

Original Issue Date

06/22/2009

Effective Date

01/26/2010

Expiration Date

03/31/2012

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/16/2012