MARK R BARLOW OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****05

License Status

NOT RENEWED

Business

Title

First Name

MARK

Middle

Last Name

BARLOW

Business Name

MARK R BARLOW OD

Original Issue Date

06/26/1996

Effective Date

05/18/2000

Expiration Date

03/31/2000

City

CENTRALIA

State

Zip

62864

County

JEFFERSON

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/18/2006