SUSANNA C FOSTIAK Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047933812

License Status

CANCELLED

Business

First Name

SUSANNA C

Last Name

FOSTIAK

Business Name

SUSANNA C FOSTIAK

Original Issue Date

03/03/2008

Effective Date

03/03/2008

Expiration Date

03/31/2010

City

LINCOLNSHIRE

State

Zip

60069

County

LAKE

Ever Disciplined

LastModifiedDate

05/04/2010