CHANTAL H JACQUES Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****41

License Status

NOT RENEWED

Business

First Name

CHANTAL

Middle

Last Name

JACQUES

Business Name

CHANTAL H JACQUES

Original Issue Date

03/15/2010

Effective Date

02/28/2012

Expiration Date

03/31/2014

City

SAINT LOUIS

State

Zip

63130

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/06/2014