ANDREW THOMAS CLARK OD - Optometrist License in Illinois | # 047931366

ANDREW THOMAS CLARK OD

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047931366

License Status

CANCELLED

Business

N

First Name

ANDREW

Middle

THOMAS

Last Name

CLARK

Suffix

OD

Business Name

ANDREW THOMAS CLARK OD

Original Issue Date

08/12/2005

Effective Date

01/10/2008

Expiration Date

03/31/2010

State

IL

Ever Disciplined

N

LastModifiedDate

05/04/2010