QUENTIN GIN PARK OD - Optometrist License in Illinois | # 047930592

QUENTIN GIN PARK OD

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930592

License Status

NOT RENEWED

Business

N

First Name

QUENTIN

Middle

GIN

Last Name

PARK

Suffix

OD

Business Name

QUENTIN GIN PARK OD

Original Issue Date

09/16/2004

Effective Date

09/16/2004

Expiration Date

03/31/2006

State

IL

Ever Disciplined

N

LastModifiedDate

05/11/2006