PATRICK E DAVIDSON OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****34

License Status

NOT RENEWED

Business

First Name

PATRICK E

Last Name

DAVIDSON

Suffix

Business Name

PATRICK E DAVIDSON OD

Original Issue Date

04/04/1997

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/18/2006