MARK WILMOTH OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****16

License Status

NOT RENEWED

Business

First Name

MARK

Last Name

WILMOTH

Suffix

Business Name

MARK WILMOTH OD

Original Issue Date

03/30/1999

Effective Date

05/18/2000

Expiration Date

03/31/2000

City

BLOOMINGDALE

State

Zip

60108

County

DUPAGE

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/18/2006