TINA RENAE PORZUKOWIAK OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047933100

License Status

NOT RENEWED

Business

First Name

TINA

Middle

RENAE

Last Name

PORZUKOWIAK

Suffix

Business Name

TINA RENAE PORZUKOWIAK OD

Original Issue Date

06/26/2007

Effective Date

06/26/2007

Expiration Date

03/31/2008

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/02/2008