MARK D REVERE - Optometrist License in Illinois | # 047007146

MARK D REVERE

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047007146

License Status

NOT RENEWED

Business

N

First Name

MARK D

Last Name

REVERE

Business Name

MARK D REVERE

Original Issue Date

08/02/1979

Expiration Date

01/01/1997

State

IL

Ever Disciplined

N

LastModifiedDate

09/01/2005