MICHAEL ANTHONY CISZEK OD - Optometrist License in Illinois | # 047931630

MICHAEL ANTHONY CISZEK OD

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047931630

License Status

CANCELLED

Business

N

First Name

MICHAEL

Middle

ANTHONY

Last Name

CISZEK

Suffix

OD

Business Name

MICHAEL ANTHONY CISZEK OD

Original Issue Date

12/07/2005

Effective Date

01/10/2008

Expiration Date

03/31/2010

State

IL

Ever Disciplined

N

LastModifiedDate

05/04/2010