CAROLYN C GIBSON OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047928665

License Status

NOT RENEWED

Business

Title

First Name

CAROLYN

Middle

Last Name

GIBSON

Business Name

CAROLYN C GIBSON OD

Original Issue Date

05/02/2002

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

CHESTER

State

Zip

62233

County

RANDOLPH

Ever Disciplined

LastModifiedDate

09/11/2005