KEITH KOWALSKE OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****55

License Status

NOT RENEWED

Business

First Name

KEITH

Last Name

KOWALSKE

Suffix

Business Name

KEITH KOWALSKE OD

Original Issue Date

10/14/1998

Effective Date

04/02/2014

Expiration Date

03/31/2016

City

EAST PEORIA

State

Zip

61611

County

TAZEWELL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/20/2016