DAMON W MACKERT OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047931427

License Status

NOT RENEWED

Business

First Name

DAMON W

Last Name

MACKERT

Suffix

Business Name

DAMON W MACKERT OD

Original Issue Date

08/25/2005

Effective Date

08/25/2005

Expiration Date

03/31/2006

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/11/2006