SUSANNA C FOSTIAK Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047934705

License Status

CANCELLED

Business

First Name

SUSANNA C

Last Name

FOSTIAK

Business Name

SUSANNA C FOSTIAK

Original Issue Date

10/04/2008

Effective Date

10/04/2008

Expiration Date

03/31/2010

City

ARLINGTON HEIGHTS

State

Zip

60004

County

COOK

Ever Disciplined

LastModifiedDate

05/04/2010