MALGORZATA KIWACZ OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047935864

License Status

CANCELLED

Business

Title

First Name

MALGORZATA

Last Name

KIWACZ

Business Name

MALGORZATA KIWACZ OD

Original Issue Date

11/19/2009

Effective Date

11/19/2009

Expiration Date

03/31/2010

City

CHICAGO

State

Zip

60659

County

COOK

Ever Disciplined

LastModifiedDate

05/04/2010