DAVID DICK OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****30

License Status

CANCELLED

Business

First Name

DAVID

Last Name

DICK

Suffix

Business Name

DAVID DICK OD

Original Issue Date

03/18/1998

Effective Date

04/05/2004

Expiration Date

03/31/2006

City

ROCK ISLAND

State

Zip

61201

County

ROCK ISLAND

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/18/2006