ROMAN V KLODNYCKY OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047925220

License Status

NOT RENEWED

Business

Title

First Name

ROMAN V

Last Name

KLODNYCKY

Business Name

ROMAN V KLODNYCKY OD

Original Issue Date

02/05/1997

Effective Date

06/12/1999

Expiration Date

03/31/1998

City

MACOMB

State

Zip

61455

County

MCDONOUGH

Ever Disciplined

LastModifiedDate

09/01/2005