DINA RUTH DAVIS OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****54

License Status

NOT RENEWED

Business

First Name

DINA

Middle

RUTH

Last Name

DAVIS

Suffix

Business Name

DINA RUTH DAVIS OD

Original Issue Date

06/04/1996

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

MOUNT PROSPECT

State

Zip

60056

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/11/2005