TIMOTHY I MILLER OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****42

License Status

NOT RENEWED

Business

First Name

TIMOTHY

Middle

Last Name

MILLER

Suffix

Business Name

TIMOTHY I MILLER OD

Original Issue Date

08/09/1996

Effective Date

03/26/2014

Expiration Date

03/31/2016

City

OTTAWA

State

Zip

61350

County

LA SALLE

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/20/2016