MICHAEL ANTHONY CISZEK OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047038625

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

ANTHONY

Last Name

CISZEK

Suffix

Business Name

MICHAEL ANTHONY CISZEK OD

Original Issue Date

07/10/1996

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

CHICAGO

State

Zip

60606

County

COOK

Ever Disciplined

LastModifiedDate

09/11/2005