THOMAS K BIALECKE OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047931560

License Status

NOT RENEWED

Business

Title

First Name

THOMAS

Middle

Last Name

BIALECKE

Business Name

THOMAS K BIALECKE OD

Original Issue Date

10/18/2005

Effective Date

01/18/2006

Expiration Date

03/31/2008

City

LOVES PARK

State

Zip

61111

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

01/10/2008