MARY AGNES BIGELOW DO Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****75

License Status

NOT RENEWED

Business

First Name

MARY

Middle

AGNES

Last Name

BIGELOW

Suffix

Business Name

MARY AGNES BIGELOW DO

Original Issue Date

06/28/2007

Effective Date

01/19/2012

Expiration Date

03/31/2014

City

MARION

State

Zip

62959

County

WILLIAMSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/06/2014