MARK R BARLOW OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****52

License Status

NOT RENEWED

Business

Title

First Name

MARK

Middle

Last Name

BARLOW

Business Name

MARK R BARLOW OD

Original Issue Date

11/16/2004

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

CENTRALIA

State

Zip

62801

County

MARION

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/04/2010