JAMES MITCHELL POLONCAK Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047928220

License Status

NOT RENEWED

Business

First Name

JAMES

Middle

MITCHELL

Last Name

POLONCAK

Business Name

JAMES MITCHELL POLONCAK

Original Issue Date

10/09/2001

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

NORTHBROOK

State

Zip

60062

County

COOK

Ever Disciplined

LastModifiedDate

09/11/2005