DAMON W MACKERT OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047931428

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

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

05/11/2006