TINA RENAE PORZUKOWIAK OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST

License Number

046009812

License Status

NOT RENEWED

Business

First Name

TINA

Middle

RENAE

Last Name

PORZUKOWIAK

Suffix

Business Name

TINA RENAE PORZUKOWIAK OD

Original Issue Date

08/24/2005

Effective Date

01/18/2006

Expiration Date

03/31/2008

City

GLENDALE

State

Zip

85308

County

ARIZONA

Ever Disciplined

LastModifiedDate

05/02/2008