MARK DOUGLAS HAHN OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047928855

License Status

CANCELLED

Business

First Name

MARK

Middle

DOUGLAS

Last Name

HAHN

Suffix

Business Name

MARK DOUGLAS HAHN OD

Original Issue Date

08/14/2002

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

PEORIA

State

Zip

61614

County

PEORIA

Ever Disciplined

LastModifiedDate

05/04/2010