MARK A YATES Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****81

License Status

NOT RENEWED

Business

First Name

MARK A

Last Name

YATES

Business Name

MARK A YATES

Original Issue Date

09/06/1996

Effective Date

01/16/2018

Expiration Date

09/30/2020

City

MARYVILLE

State

Zip

62062

County

MADISON

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021