KEVIN T GRALAK OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047929902

License Status

NOT RENEWED

Business

First Name

KEVIN

Middle

Last Name

GRALAK

Suffix

Business Name

KEVIN T GRALAK OD

Original Issue Date

12/11/2003

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Ever Disciplined

LastModifiedDate

09/11/2005