MARTIN W PAROD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****61

License Status

NOT RENEWED

Business

First Name

MARTIN W

Last Name

PAROD

Business Name

MARTIN W PAROD

Original Issue Date

04/15/1996

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

GALESBURG

State

Zip

61401

County

KNOX

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/11/2005