KELLY MARIE DAUGHERTY ZIELASKOWSKI Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****99

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

MARIE

Last Name

DAUGHERTY ZIELASKOWSKI

Business Name

KELLY MARIE DAUGHERTY ZIELASKOWSKI

Original Issue Date

08/01/2007

Effective Date

03/10/2014

Expiration Date

03/31/2016

City

LIBERTYVILLE

State

Zip

60048

County

LAKE

Specialty/Qualifier

HOSPITAL/CLINIC

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/20/2016