DONALD MAZZULLA OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047007110

License Status

NOT RENEWED

Business

First Name

DONALD

Last Name

MAZZULLA

Suffix

Business Name

DONALD MAZZULLA OD

Original Issue Date

07/23/1986

Expiration Date

03/31/1988

City

COUNTRY CLUB HILLS

State

Zip

60477

County

COOK

Ever Disciplined

LastModifiedDate

09/01/2005