MARK COULTER RAFFERTY OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****24

License Status

NOT RENEWED

Business

First Name

MARK

Middle

COULTER

Last Name

RAFFERTY

Suffix

Business Name

MARK COULTER RAFFERTY OD

Original Issue Date

02/19/1998

Effective Date

03/19/2014

Expiration Date

03/31/2016

City

NAPERVILLE

State

Zip

60540

County

DUPAGE

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/20/2016