THOMAS F STAZAK OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047006373

License Status

NOT RENEWED

Business

First Name

THOMAS

Middle

Last Name

STAZAK

Suffix

Business Name

THOMAS F STAZAK OD

Original Issue Date

09/21/1973

Expiration Date

01/01/1997

City

ORLAND PARK

State

Zip

60462

County

COOK

Ever Disciplined

LastModifiedDate

09/01/2005