GEORGE MICHAEL NISTA OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047929175

License Status

NOT RENEWED

Business

First Name

GEORGE

Middle

MICHAEL

Last Name

NISTA

Suffix

Business Name

GEORGE MICHAEL NISTA OD

Original Issue Date

11/26/2002

Effective Date

02/19/2004

Expiration Date

03/31/2006

City

CHICAGO

State

Zip

60635

County

COOK

Ever Disciplined

LastModifiedDate

05/11/2006