KEVIN T GRALAK 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

KEVIN

Middle

Last Name

GRALAK

Suffix

Business Name

KEVIN T GRALAK OD

Original Issue Date

01/31/2005

Effective Date

01/31/2005

Expiration Date

03/31/2006

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/11/2006