MARK E FERGUSON Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047928394

License Status

NOT RENEWED

Business

First Name

MARK

Middle

Last Name

FERGUSON

Business Name

MARK E FERGUSON

Original Issue Date

01/31/2002

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Ever Disciplined

LastModifiedDate

09/11/2005