MICHAEL S WACLAWSKI OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****85

License Status

NOT RENEWED

Business

Title

First Name

MICHAEL

Middle

Last Name

WACLAWSKI

Business Name

MICHAEL S WACLAWSKI OD

Original Issue Date

08/05/2014

Effective Date

08/05/2014

Expiration Date

03/31/2016

City

SHILOH

State

Zip

62269

County

SAINT CLAIR

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/20/2016