KEVIN T GRALAK OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930901

License Status

NOT RENEWED

Business

First Name

KEVIN

Middle

Last Name

GRALAK

Suffix

Business Name

KEVIN T GRALAK OD

Original Issue Date

02/22/2005

Effective Date

02/22/2005

Expiration Date

03/31/2006

City

QUINCY

State

Zip

62301

County

ADAMS

Ever Disciplined

LastModifiedDate

05/11/2006