MARK WILMOTH OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****12

License Status

NOT RENEWED

Business

First Name

MARK

Last Name

WILMOTH

Suffix

Business Name

MARK WILMOTH OD

Original Issue Date

07/07/2000

Effective Date

05/24/2004

Expiration Date

03/31/2006

City

OAK LAWN

State

Zip

60453

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/11/2006