DOROTA M CZAICKA OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047935445

License Status

CANCELLED

Business

First Name

DOROTA

Middle

Last Name

CZAICKA

Suffix

Business Name

DOROTA M CZAICKA OD

Original Issue Date

06/25/2009

Effective Date

06/25/2009

Expiration Date

03/31/2010

City

MELROSE PARK

State

Zip

60160

County

COOK

Ever Disciplined

LastModifiedDate

05/04/2010