JENNIFER SUSAN MAHURIN OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****91

License Status

NOT RENEWED

Business

First Name

JENNIFER

Middle

SUSAN

Last Name

MAHURIN

Suffix

Business Name

JENNIFER SUSAN MAHURIN OD

Original Issue Date

12/12/2000

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

FAIRVIEW HEIGHTS

State

Zip

62208

County

SAINT CLAIR

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/04/2010