KENNETH RONALD MINARIK OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047037285

License Status

CANCELLED

Business

First Name

KENNETH

Middle

RONALD

Last Name

MINARIK

Suffix

Business Name

KENNETH RONALD MINARIK OD

Original Issue Date

06/10/1992

Effective Date

02/15/2000

Expiration Date

03/31/2000

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

09/01/2005