DOROTA M CZAICKA OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047932015

License Status

CANCELLED

Business

First Name

DOROTA

Middle

Last Name

CZAICKA

Suffix

Business Name

DOROTA M CZAICKA OD

Original Issue Date

04/17/2006

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

CRYSTAL LAKE

State

Zip

60014

County

MCHENRY

Ever Disciplined

LastModifiedDate

05/04/2010