GUILLERMO GAMBOA OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047929901

License Status

NOT RENEWED

Business

First Name

GUILLERMO

Last Name

GAMBOA

Suffix

Business Name

GUILLERMO GAMBOA OD

Original Issue Date

12/11/2003

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

CHICAGO

State

Zip

60655

County

COOK

Ever Disciplined

LastModifiedDate

09/11/2005