MARK D WADE OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****89

License Status

NOT RENEWED

Business

Title

First Name

MARK

Middle

Last Name

WADE

Business Name

MARK D WADE OD

Original Issue Date

12/12/2006

Effective Date

04/01/2016

Expiration Date

03/31/2018

City

ST LOUIS

State

Zip

63108

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/19/2018