JAMES MITCHELL POLONCAK Optometrist License verification

Business Entity

INACTIVE

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047928261

License Status

INACTIVE

Business

First Name

JAMES

Middle

MITCHELL

Last Name

POLONCAK

Business Name

JAMES MITCHELL POLONCAK

Original Issue Date

10/31/2001

Effective Date

03/10/2004

Expiration Date

03/31/2004

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Ever Disciplined

LastModifiedDate

09/11/2005