MARK A ELLISON, LTD
Optometry at Bethalto Dr, Fort Russell, IL

License number
Illinois 046007313
Category
Optometry
Type
Optometrist
Owner
Name: DR. MARK A. ELLISON O.D.
Title: PRESIDENT
Phone: (618) 635-2424
Address
Address
422 W Bethalto Dr, Fort Russell, IL 62010
National Provider ID: 1013967116
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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MARK A. ELLISON, LTD

Fort Russell, IL

Industry:
Optometrist's Office
Doing business as:
Mark A Ellison Ltd
Registration:
Jul 15, 1985
Addresses:
Bethalto, IL 62010 (Physical)
422 W Bethalto Dr, Fort Russell, IL 62010
State ID:
53911137
Business type:
DOMESTIC BCA
Expiration:
PERPETUAL
President, Principal:
Mark Ellison (President, Principal)
Agent:
Mark A Ellison,422 W Bethalto Blvd, Bethalto, IL 62010 (Physical)

Optometry licenses in Illinois

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