BRIAN M MACKEY OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****18

License Status

NOT RENEWED

Business

First Name

BRIAN M

Last Name

MACKEY

Suffix

Business Name

BRIAN M MACKEY OD

Original Issue Date

06/26/1996

Expiration Date

03/31/1998

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/02/2005