GREGORY D JACKSON OD - Optometrist License in Illinois | # 047930392

GREGORY D JACKSON OD

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930392

License Status

NOT RENEWED

Business

N

First Name

GREGORY

Middle

D

Last Name

JACKSON

Suffix

OD

Business Name

GREGORY D JACKSON OD

Original Issue Date

07/07/2004

Effective Date

07/07/2004

Expiration Date

03/31/2006

State

IL

Ever Disciplined

N

LastModifiedDate

05/11/2006