MARK D WADE OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047008455

License Status

NOT RENEWED

Business

Title

First Name

MARK

Middle

Last Name

WADE

Business Name

MARK D WADE OD

Original Issue Date

01/08/1997

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

FAIRVIEW HEIGHTS

State

Zip

62208

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

03/24/2006