MICHAEL E TABERNACKI OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047008140

License Status

NOT RENEWED

Business

First Name

MICHAEL E

Last Name

TABERNACKI

Suffix

Business Name

MICHAEL E TABERNACKI OD

Original Issue Date

09/27/1988

Expiration Date

03/31/1992

City

NORTH RIVERSIDE

State

Zip

60546

County

COOK

Ever Disciplined

LastModifiedDate

09/01/2005