MICHAEL N PALANCA Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****28

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

Last Name

PALANCA

Business Name

MICHAEL N PALANCA

Original Issue Date

08/14/2000

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/11/2005