TINA RENAE PORZUKOWIAK OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047933120

License Status

NOT RENEWED

Business

First Name

TINA

Middle

RENAE

Last Name

PORZUKOWIAK

Suffix

Business Name

TINA RENAE PORZUKOWIAK OD

Original Issue Date

07/02/2007

Effective Date

07/02/2007

Expiration Date

03/31/2008

City

CRYSTAL LAKE

State

Zip

60014

County

MCHENRY

Ever Disciplined

LastModifiedDate

05/02/2008