MARK K COLIP OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****47

License Status

NOT RENEWED

Business

First Name

MARK K

Last Name

COLIP

Suffix

Business Name

MARK K COLIP OD

Original Issue Date

04/07/1997

Effective Date

03/22/2018

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60616

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021