TINA RENAE PORZUKOWIAK OD Optometrist License verification

Business Entity

INACTIVE

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047932226

License Status

INACTIVE

Business

First Name

TINA

Middle

RENAE

Last Name

PORZUKOWIAK

Suffix

Business Name

TINA RENAE PORZUKOWIAK OD

Original Issue Date

05/05/2006

Effective Date

05/05/2006

Expiration Date

03/31/2008

City

BLOOMINGDALE

State

Zip

60108

County

DUPAGE

Ever Disciplined

LastModifiedDate

05/05/2006