MARY BETH GORAZD OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****79

License Status

NOT RENEWED

Business

First Name

MARY

Middle

BETH

Last Name

GORAZD

Suffix

Business Name

MARY BETH GORAZD OD

Original Issue Date

11/17/1998

Effective Date

04/24/2012

Expiration Date

03/31/2014

City

OFALLON

State

Zip

62269

County

SAINT CLAIR

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/06/2014