KRISTIN M SKLUZACEK OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****69

License Status

NOT RENEWED

Business

First Name

KRISTIN

Middle

Last Name

SKLUZACEK

Suffix

Business Name

KRISTIN M SKLUZACEK OD

Original Issue Date

06/27/2007

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

CHICAGO

State

Zip

60616

County

COOK

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/04/2010