MARK R BARLOW OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930720

License Status

CANCELLED

Business

Title

First Name

MARK

Middle

Last Name

BARLOW

Business Name

MARK R BARLOW OD

Original Issue Date

11/15/2004

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

CENTRALIA

State

Zip

62801

County

MARION

Ever Disciplined

LastModifiedDate

05/04/2010