KEITH KOWALSKE OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047926046

License Status

CANCELLED

Business

First Name

KEITH

Last Name

KOWALSKE

Suffix

Business Name

KEITH KOWALSKE OD

Original Issue Date

12/23/1998

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

NORMAL

State

Zip

61761

County

MCLEAN

Ever Disciplined

LastModifiedDate

05/04/2010