This answer is for anyone encountering pdfs with images and needing to use OCR. I could not find a workable off-the-shelf solution; nothing that gave me the accuracy I needed.
Here are the steps I found to work.
- Use - pdfimagesfrom https://poppler.freedesktop.org/ to turn the pages of the pdf into images.
 
- Use Tesseract to detect rotation and ImageMagick - mogrifyto fix it.
 
- Use OpenCV to find and extract tables. 
- Use OpenCV to find and extract each cell from the table. 
- Use OpenCV to crop and clean up each cell so that there is no noise that will confuse OCR software. 
- Use Tesseract to OCR each cell. 
- Combine the extracted text of each cell into the format you need. 
I wrote a python package with modules that can help with those steps.
Repo: https://github.com/eihli/image-table-ocr
Docs & Source: https://eihli.github.io/image-table-ocr/pdf_table_extraction_and_ocr.html 
Some of the steps don't require code, they take advantage of external tools like pdfimages and tesseract. I'll provide some brief examples for a couple of the steps that do require code.
- Finding tables:
This link was a good reference while figuring out how to find tables. https://answers.opencv.org/question/63847/how-to-extract-tables-from-an-image/
import cv2
def find_tables(image):
    BLUR_KERNEL_SIZE = (17, 17)
    STD_DEV_X_DIRECTION = 0
    STD_DEV_Y_DIRECTION = 0
    blurred = cv2.GaussianBlur(image, BLUR_KERNEL_SIZE, STD_DEV_X_DIRECTION, STD_DEV_Y_DIRECTION)
    MAX_COLOR_VAL = 255
    BLOCK_SIZE = 15
    SUBTRACT_FROM_MEAN = -2
    img_bin = cv2.adaptiveThreshold(
        ~blurred,
        MAX_COLOR_VAL,
        cv2.ADAPTIVE_THRESH_MEAN_C,
        cv2.THRESH_BINARY,
        BLOCK_SIZE,
        SUBTRACT_FROM_MEAN,
    )
    vertical = horizontal = img_bin.copy()
    SCALE = 5
    image_width, image_height = horizontal.shape
    horizontal_kernel = cv2.getStructuringElement(cv2.MORPH_RECT, (int(image_width / SCALE), 1))
    horizontally_opened = cv2.morphologyEx(img_bin, cv2.MORPH_OPEN, horizontal_kernel)
    vertical_kernel = cv2.getStructuringElement(cv2.MORPH_RECT, (1, int(image_height / SCALE)))
    vertically_opened = cv2.morphologyEx(img_bin, cv2.MORPH_OPEN, vertical_kernel)
    horizontally_dilated = cv2.dilate(horizontally_opened, cv2.getStructuringElement(cv2.MORPH_RECT, (40, 1)))
    vertically_dilated = cv2.dilate(vertically_opened, cv2.getStructuringElement(cv2.MORPH_RECT, (1, 60)))
    mask = horizontally_dilated + vertically_dilated
    contours, hierarchy = cv2.findContours(
        mask, cv2.RETR_EXTERNAL, cv2.CHAIN_APPROX_SIMPLE,
    )
    MIN_TABLE_AREA = 1e5
    contours = [c for c in contours if cv2.contourArea(c) > MIN_TABLE_AREA]
    perimeter_lengths = [cv2.arcLength(c, True) for c in contours]
    epsilons = [0.1 * p for p in perimeter_lengths]
    approx_polys = [cv2.approxPolyDP(c, e, True) for c, e in zip(contours, epsilons)]
    bounding_rects = [cv2.boundingRect(a) for a in approx_polys]
    # The link where a lot of this code was borrowed from recommends an
    # additional step to check the number of "joints" inside this bounding rectangle.
    # A table should have a lot of intersections. We might have a rectangular image
    # here though which would only have 4 intersections, 1 at each corner.
    # Leaving that step as a future TODO if it is ever necessary.
    images = [image[y:y+h, x:x+w] for x, y, w, h in bounding_rects]
    return images
- Extract cells from table.
This is very similar to 2, so I won't include all the code. The part I will reference will be in sorting the cells.
We want to identify the cells from left-to-right, top-to-bottom.
We’ll find the rectangle with the most top-left corner. Then we’ll find all of the rectangles that have a center that is within the top-y and bottom-y values of that top-left rectangle. Then we’ll sort those rectangles by the x value of their center. We’ll remove those rectangles from the list and repeat.
def cell_in_same_row(c1, c2):
    c1_center = c1[1] + c1[3] - c1[3] / 2
    c2_bottom = c2[1] + c2[3]
    c2_top = c2[1]
    return c2_top < c1_center < c2_bottom
orig_cells = [c for c in cells]
rows = []
while cells:
    first = cells[0]
    rest = cells[1:]
    cells_in_same_row = sorted(
        [
            c for c in rest
            if cell_in_same_row(c, first)
        ],
        key=lambda c: c[0]
    )
    row_cells = sorted([first] + cells_in_same_row, key=lambda c: c[0])
    rows.append(row_cells)
    cells = [
        c for c in rest
        if not cell_in_same_row(c, first)
    ]
# Sort rows by average height of their center.
def avg_height_of_center(row):
    centers = [y + h - h / 2 for x, y, w, h in row]
    return sum(centers) / len(centers)
rows.sort(key=avg_height_of_center)