MIRKA SULC OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****14

License Status

NOT RENEWED

Business

First Name

MIRKA

Last Name

SULC

Suffix

Business Name

MIRKA SULC OD

Original Issue Date

03/11/1997

Effective Date

05/18/2000

Expiration Date

03/31/2000

City

CHICAGO

State

Zip

60622

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/11/2005