VIVIAN M KLOKE OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930965

License Status

CANCELLED

Business

First Name

VIVIAN

Middle

Last Name

KLOKE

Suffix

Business Name

VIVIAN M KLOKE OD

Original Issue Date

03/10/2005

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

EAST SAINT LOUIS

State

Zip

62201

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

05/04/2010