DAVID H ELLIS OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****67

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

Last Name

ELLIS

Suffix

Business Name

DAVID H ELLIS OD

Original Issue Date

05/07/1996

Effective Date

02/25/2014

Expiration Date

03/31/2016

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/20/2016