KEVIN T GRALAK OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930054

License Status

NOT RENEWED

Business

First Name

KEVIN

Middle

Last Name

GRALAK

Suffix

Business Name

KEVIN T GRALAK OD

Original Issue Date

03/23/2004

Effective Date

03/23/2004

Expiration Date

03/31/2006

City

MACHESNEY PARK

State

Zip

61115

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/11/2006