AMMIE MARIE CHIZEK OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****17

License Status

NOT RENEWED

Business

First Name

AMMIE

Middle

MARIE

Last Name

CHIZEK

Suffix

Business Name

AMMIE MARIE CHIZEK OD

Original Issue Date

09/06/2007

Effective Date

01/25/2012

Expiration Date

03/31/2014

City

ROCK ISLAND

State

Zip

61201

County

ROCK ISLAND

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/06/2014