DOUGLAS GOODWIN ROSE OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****74

License Status

NOT RENEWED

Business

First Name

DOUGLAS

Middle

GOODWIN

Last Name

ROSE

Suffix

Business Name

DOUGLAS GOODWIN ROSE OD

Original Issue Date

11/26/2007

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

BELLEVILLE

State

Zip

62221

County

SAINT CLAIR

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/04/2010