THERESA ANN HAAS OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****79

License Status

NOT RENEWED

Business

First Name

THERESA

Middle

ANN

Last Name

HAAS

Suffix

Business Name

THERESA ANN HAAS OD

Original Issue Date

03/14/2005

Effective Date

03/14/2005

Expiration Date

03/31/2006

City

BENTON

State

Zip

62812

County

FRANKLIN

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/11/2006