DANIEL PHILIP WALSH OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****41

License Status

NOT RENEWED

Business

First Name

DANIEL

Middle

PHILIP

Last Name

WALSH

Suffix

Business Name

DANIEL PHILIP WALSH OD

Original Issue Date

05/08/2018

Effective Date

05/08/2018

Expiration Date

09/30/2020

City

GLEN CARBON

State

Zip

62034

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021