GEORGE MICHAEL NISTA OD - Optometrist License in Illinois | # 047934996

GEORGE MICHAEL NISTA OD

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047934996

License Status

CANCELLED

Business

N

First Name

GEORGE

Middle

MICHAEL

Last Name

NISTA

Suffix

OD

Business Name

GEORGE MICHAEL NISTA OD

Original Issue Date

01/10/2009

Effective Date

01/10/2009

Expiration Date

03/31/2010

State

IL

Ever Disciplined

N

LastModifiedDate

05/04/2010