DAVID W MILLER OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****61

License Status

NOT RENEWED

Business

Title

First Name

DAVID W

Last Name

MILLER

Business Name

DAVID W MILLER OD

Original Issue Date

04/22/1996

Effective Date

03/29/2016

Expiration Date

03/31/2018

City

DECATUR

State

Zip

62526

County

MACON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

06/19/2018