MARK D WADE OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047927351

License Status

CANCELLED

Business

Title

First Name

MARK

Middle

Last Name

WADE

Business Name

MARK D WADE OD

Original Issue Date

08/23/2000

Effective Date

09/17/2008

Expiration Date

03/31/2010

City

FAIRVIEW HEIGHTS

State

Zip

62208

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

05/04/2010