JENNIFER MARIE WILSON OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****56

License Status

NOT RENEWED

Business

Title

First Name

JENNIFER

Middle

MARIE

Last Name

WILSON

Business Name

JENNIFER MARIE WILSON OD

Original Issue Date

06/25/2014

Effective Date

03/11/2020

Expiration Date

05/31/2022

City

WASHINGTON

State

Zip

61571

County

TAZEWELL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

07/27/2022