THOMAS F STAZAK OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****04

License Status

NOT RENEWED

Business

First Name

THOMAS

Middle

Last Name

STAZAK

Suffix

Business Name

THOMAS F STAZAK OD

Original Issue Date

05/07/1996

Effective Date

03/11/2022

Expiration Date

03/31/2024

City

LISLE

State

Zip

60532

County

DUPAGE

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

02/05/2025