DONALD MAZZULLA OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047207110

License Status

NOT RENEWED

Business

First Name

DONALD

Last Name

MAZZULLA

Suffix

Business Name

DONALD MAZZULLA OD

Original Issue Date

02/20/1987

Expiration Date

03/31/1990

City

CHICAGO HEIGHTS

State

Zip

60411

County

COOK

Ever Disciplined

LastModifiedDate

09/01/2005