CLARK E DESHON OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****15

License Status

NOT RENEWED

Business

First Name

CLARK E

Last Name

DESHON

Suffix

Business Name

CLARK E DESHON OD

Original Issue Date

05/29/2002

Effective Date

03/22/2004

Expiration Date

03/31/2006

City

OLNEY

State

Zip

62450

County

RICHLAND

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/11/2006