GINA MARIE PIPER OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047931115

License Status

NOT RENEWED

Business

First Name

GINA

Middle

MARIE

Last Name

PIPER

Suffix

Business Name

GINA MARIE PIPER OD

Original Issue Date

04/21/2005

Effective Date

04/21/2005

Expiration Date

03/31/2006

City

CHICAGO RIDGE

State

Zip

60415

County

COOK

Ever Disciplined

LastModifiedDate

05/11/2006