MARK A BREI OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****17

License Status

NOT RENEWED

Business

First Name

MARK A

Last Name

BREI

Suffix

Business Name

MARK A BREI OD

Original Issue Date

07/23/2021

Effective Date

03/05/2022

Expiration Date

03/31/2024

City

QUINCY

State

Zip

62301

County

ADAMS

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025