ADAM P WIRA OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****17

License Status

NOT RENEWED

Business

Title

First Name

ADAM

Middle

Last Name

WIRA

Business Name

ADAM P WIRA OD

Original Issue Date

11/27/2019

Effective Date

11/27/2019

Expiration Date

09/30/2020

City

SAINT LOUIS

State

Zip

63129

County

MISSOURI

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/14/2021