MARK E BREWER OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****76

License Status

NOT RENEWED

Business

First Name

MARK E

Last Name

BREWER

Suffix

Business Name

MARK E BREWER OD

Original Issue Date

11/06/1997

Effective Date

01/04/2020

Expiration Date

05/31/2022

City

EAST PEORIA

State

Zip

61611

County

TAZEWELL

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

07/27/2022