MARK V GRAVES OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****36

License Status

NOT RENEWED

Business

First Name

MARK

Middle

Last Name

GRAVES

Suffix

Business Name

MARK V GRAVES OD

Original Issue Date

09/10/1998

Effective Date

01/04/2020

Expiration Date

05/31/2022

City

BERWYN

State

Zip

60402

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

07/27/2022