KENNETH E CLARK Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047106111

License Status

CANCELLED

Business

First Name

KENNETH E

Last Name

CLARK

Business Name

KENNETH E CLARK

Original Issue Date

05/28/1975

Expiration Date

01/01/1997

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Ever Disciplined

LastModifiedDate

09/01/2005