DANIEL PHILIP WALSH OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****98

License Status

NOT RENEWED

Business

First Name

DANIEL

Middle

PHILIP

Last Name

WALSH

Suffix

Business Name

DANIEL PHILIP WALSH OD

Original Issue Date

06/07/2000

Effective Date

03/10/2016

Expiration Date

03/31/2018

City

ALTON

State

Zip

62002

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

06/19/2018