JACK MALLEN Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST

License Number

046004199

License Status

NOT RENEWED

Business

First Name

JACK

Last Name

MALLEN

Business Name

JACK MALLEN

Expiration Date

03/31/1986

City

FAIRVIEW HEIGHTS

State

Zip

62208

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

08/31/2005