MARY BETH GORAZD OD 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

MARY

Middle

BETH

Last Name

GORAZD

Suffix

Business Name

MARY BETH GORAZD OD

Original Issue Date

11/19/1998

Effective Date

05/18/2000

Expiration Date

03/31/2000

City

FAIRVEIW HEIGHTS

State

Zip

62208

County

SAINT CLAIR

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/18/2006