ANDREW THOMAS CLARK OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047047654

License Status

NOT RENEWED

Business

First Name

ANDREW

Middle

THOMAS

Last Name

CLARK

Suffix

Business Name

ANDREW THOMAS CLARK OD

Original Issue Date

12/03/1993

Expiration Date

03/31/1996

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

09/01/2005