DAVID A WAGERS OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****95

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

Last Name

WAGERS

Suffix

Business Name

DAVID A WAGERS OD

Original Issue Date

09/09/1997

Effective Date

05/18/2000

Expiration Date

03/31/2000

City

PEORIA

State

Zip

61613

County

HENRY

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/11/2005