TIFFANY LYNN POLANEK OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047929759

License Status

NOT RENEWED

Business

First Name

TIFFANY

Middle

LYNN

Last Name

POLANEK

Suffix

Business Name

TIFFANY LYNN POLANEK OD

Original Issue Date

10/16/2003

Effective Date

02/25/2004

Expiration Date

03/31/2006

City

CHICAGO

State

Zip

60657

County

COOK

Ever Disciplined

LastModifiedDate

05/11/2006