DOROTA M CZAICKA OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930595

License Status

NOT RENEWED

Business

First Name

DOROTA

Middle

Last Name

CZAICKA

Suffix

Business Name

DOROTA M CZAICKA OD

Original Issue Date

09/17/2004

Effective Date

09/17/2004

Expiration Date

03/31/2006

City

BERWYN

State

Zip

60402

County

COOK

Ever Disciplined

LastModifiedDate

05/11/2006