DENNIS JOHN ELS OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****73

License Status

NOT RENEWED

Business

First Name

DENNIS

Middle

JOHN

Last Name

ELS

Suffix

Business Name

DENNIS JOHN ELS OD

Original Issue Date

11/20/2000

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

CENTRALIA

State

Zip

62801

County

MARION

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/18/2006