KATHLEEN A MAES-PUKALA OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****71

License Status

NOT RENEWED

Business

First Name

KATHLEEN

Middle

Last Name

MAES-PUKALA

Suffix

Business Name

KATHLEEN A MAES-PUKALA OD

Original Issue Date

04/19/2010

Effective Date

04/04/2012

Expiration Date

03/31/2014

City

TINLEY PARK

State

Zip

60487

County

COOK

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/06/2014