KELLY MARIE DAUGHERTY ZIELASKOWSKI Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****30

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

MARIE

Last Name

DAUGHERTY ZIELASKOWSKI

Business Name

KELLY MARIE DAUGHERTY ZIELASKOWSKI

Original Issue Date

09/21/2007

Effective Date

02/17/2010

Expiration Date

03/31/2012

City

ARLINGTON HEIGHTS

State

Zip

60004

County

COOK

Specialty/Qualifier

HOSPITAL/CLINIC

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/16/2012