TIFFANY LYNN POLANEK OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047932970

License Status

CANCELLED

Business

First Name

TIFFANY

Middle

LYNN

Last Name

POLANEK

Suffix

Business Name

TIFFANY LYNN POLANEK OD

Original Issue Date

04/19/2007

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

CHICAGO

State

Zip

60622

County

COOK

Ever Disciplined

LastModifiedDate

05/04/2010