MIA J GUILLORY OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****65

License Status

NOT RENEWED

Business

First Name

MIA

Middle

Last Name

GUILLORY

Suffix

Business Name

MIA J GUILLORY OD

Original Issue Date

04/12/2010

Effective Date

02/26/2018

Expiration Date

09/30/2020

City

MARION

State

Zip

62959

County

WILLIAMSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

01/14/2021