GEORGE MICHAEL NISTA OD - Optometrist License in Illinois | # 047026886

GEORGE MICHAEL NISTA OD

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047026886

License Status

NOT RENEWED

Business

N

First Name

GEORGE

Middle

MICHAEL

Last Name

NISTA

Suffix

OD

Business Name

GEORGE MICHAEL NISTA OD

Original Issue Date

05/09/1992

Expiration Date

03/31/1998

State

IL

Ever Disciplined

N

LastModifiedDate

09/01/2005