STEPHANIE ANN KLEMENCIC OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047933327

License Status

CANCELLED

Business

First Name

STEPHANIE

Middle

ANN

Last Name

KLEMENCIC

Suffix

Business Name

STEPHANIE ANN KLEMENCIC OD

Original Issue Date

08/22/2007

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

CHICAGO

State

Zip

60607

County

COOK

Ever Disciplined

LastModifiedDate

05/04/2010