MARK A ELLISON Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047107313

License Status

NOT RENEWED

Business

First Name

MARK A

Last Name

ELLISON

Business Name

MARK A ELLISON

Original Issue Date

06/27/1983

Effective Date

01/18/2006

Expiration Date

03/31/2008

City

STAUNTON

State

Zip

62088

County

MACOUPIN

Ever Disciplined

LastModifiedDate

05/02/2008