THOMAS K BIALECKE OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047506168

License Status

NOT RENEWED

Business

Title

First Name

THOMAS

Middle

Last Name

BIALECKE

Business Name

THOMAS K BIALECKE OD

Original Issue Date

09/17/1991

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

DIXON

State

Zip

61021

County

LEE

Ever Disciplined

LastModifiedDate

09/11/2005