MICHAEL E TABERNACKI OD - Optometrist License in Illinois | # 047935754

MICHAEL E TABERNACKI OD

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047935754

License Status

CANCELLED

Business

N

First Name

MICHAEL E

Last Name

TABERNACKI

Suffix

OD

Business Name

MICHAEL E TABERNACKI OD

Original Issue Date

10/07/2009

Effective Date

10/07/2009

Expiration Date

03/31/2010

State

IL

Ever Disciplined

N

LastModifiedDate

05/04/2010