MARK R BARLOW OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****93

License Status

NOT RENEWED

Business

Title

First Name

MARK

Middle

Last Name

BARLOW

Business Name

MARK R BARLOW OD

Original Issue Date

04/02/2002

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

CARMI

State

Zip

62821

County

WHITE

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/04/2010