TIFFANY LYNN POLANEK OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930748

License Status

NOT RENEWED

Business

First Name

TIFFANY

Middle

LYNN

Last Name

POLANEK

Suffix

Business Name

TIFFANY LYNN POLANEK OD

Original Issue Date

11/29/2004

Effective Date

01/18/2006

Expiration Date

03/31/2008

City

PARK RIDGE

State

Zip

60068

County

COOK

Ever Disciplined

LastModifiedDate

05/02/2008