VIVIAN M KLOKE OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047925892

License Status

CANCELLED

Business

First Name

VIVIAN

Middle

Last Name

KLOKE

Suffix

Business Name

VIVIAN M KLOKE OD

Original Issue Date

09/17/1998

Effective Date

03/10/2005

Expiration Date

03/31/2006

City

EAST SAINT LOUIS

State

Zip

62201

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

09/01/2005