MICHAEL ANTHONY CISZEK OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047931630

License Status

CANCELLED

Business

First Name

MICHAEL

Middle

ANTHONY

Last Name

CISZEK

Suffix

Business Name

MICHAEL ANTHONY CISZEK OD

Original Issue Date

12/07/2005

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

CHICAGO

State

Zip

60602

County

COOK

Ever Disciplined

LastModifiedDate

05/04/2010