MICHAEL MLYNSKI OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****85

License Status

NOT RENEWED

Business

First Name

MICHAEL

Last Name

MLYNSKI

Suffix

Business Name

MICHAEL MLYNSKI OD

Original Issue Date

08/04/2003

Effective Date

05/21/2004

Expiration Date

03/31/2006

City

ROCKFORD

State

Zip

61112

County

WINNEBAGO

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/11/2006