Section 72. Optometrists may practice and advertise under a trade or service name; provided however, that the names of the optometrist or optometrists are prominently displayed at all locations of their practice, in all print advertisements that identify the location or locations where optometric services are provided, and in the optometrist’s examining room. The name of the optometrist actually responsible for the provision of such optometric services shall be included in the same type as the address of the location; and provided, further, that the name of the optometrist shall also be printed on any prescription form.