JODIE M WADSWORTH OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****52

License Status

NOT RENEWED

Business

First Name

JODIE

Middle

Last Name

WADSWORTH

Suffix

Business Name

JODIE M WADSWORTH OD

Original Issue Date

08/04/2011

Effective Date

08/04/2011

Expiration Date

03/31/2012

City

MOUNT ZION

State

Zip

62549

County

MACON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/16/2012