MARK A BREI OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047928340

License Status

NOT RENEWED

Business

First Name

MARK A

Last Name

BREI

Suffix

Business Name

MARK A BREI OD

Original Issue Date

12/13/2001

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

SPRINGFIELD

State

Zip

62711

County

SANGAMON

Ever Disciplined

LastModifiedDate

09/11/2005