GREGORY D ACTIPES OD - Optometrist License in Illinois | # 34*****68

GREGORY D ACTIPES OD

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****68

License Status

NOT RENEWED

Business

N

First Name

GREGORY

Middle

D

Last Name

ACTIPES

Suffix

OD

Business Name

GREGORY D ACTIPES OD

Original Issue Date

04/07/1997

Effective Date

05/18/2000

Expiration Date

03/31/2000

State

IL

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

IV

Ever Disciplined

N

LastModifiedDate

01/18/2006