ANDREW THOMAS CLARK OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST

License Number

046007654

License Status

NOT RENEWED

Business

First Name

ANDREW

Middle

THOMAS

Last Name

CLARK

Suffix

Business Name

ANDREW THOMAS CLARK OD

Original Issue Date

07/28/1983

Effective Date

01/21/2020

Expiration Date

05/31/2022

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Ever Disciplined

LastModifiedDate

07/27/2022