JAMES MITCHELL POLONCAK Optometrist License verification

Business Entity

INACTIVE

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047928315

License Status

INACTIVE

Business

First Name

JAMES

Middle

MITCHELL

Last Name

POLONCAK

Business Name

JAMES MITCHELL POLONCAK

Original Issue Date

11/21/2001

Effective Date

03/11/2004

Expiration Date

03/31/2004

City

CHICAGO RIDGE

State

Zip

60415

County

COOK

Ever Disciplined

LastModifiedDate

09/11/2005