ROMAN V KLODNYCKY OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047931010

License Status

CANCELLED

Business

Title

First Name

ROMAN V

Last Name

KLODNYCKY

Business Name

ROMAN V KLODNYCKY OD

Original Issue Date

03/10/2005

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/04/2010