MICHAEL E TABERNACKI OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047208140

License Status

NOT RENEWED

Business

First Name

MICHAEL E

Last Name

TABERNACKI

Suffix

Business Name

MICHAEL E TABERNACKI OD

Original Issue Date

05/25/1991

Expiration Date

03/31/1992

City

MELROSE PARK

State

Zip

60160

County

COOK

Ever Disciplined

LastModifiedDate

09/01/2005