GINA MARIE PIPER OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930135

License Status

NOT RENEWED

Business

First Name

GINA

Middle

MARIE

Last Name

PIPER

Suffix

Business Name

GINA MARIE PIPER OD

Original Issue Date

05/26/2004

Effective Date

05/26/2004

Expiration Date

03/31/2006

City

CHICAGO

State

Zip

60652

County

COOK

Ever Disciplined

LastModifiedDate

05/11/2006