MARK B BUSCH OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047006948

License Status

CANCELLED

Business

First Name

MARK

Middle

Last Name

BUSCH

Suffix

Business Name

MARK B BUSCH OD

Original Issue Date

05/06/1986

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

COUNTRYSIDE

State

Zip

60525

County

COOK

Ever Disciplined

LastModifiedDate

05/04/2010