STEVEN J GRONDALSKI 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

STEVEN J

Last Name

GRONDALSKI

Suffix

Business Name

STEVEN J GRONDALSKI OD

Original Issue Date

01/05/1999

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

EAST ST LOUIS

State

Zip

62201

County

SAINT CLAIR

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/18/2006