QUENTIN GIN PARK OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047932845

License Status

NOT RENEWED

Business

First Name

QUENTIN

Middle

GIN

Last Name

PARK

Suffix

Business Name

QUENTIN GIN PARK OD

Original Issue Date

02/06/2007

Effective Date

02/06/2007

Expiration Date

03/31/2008

City

BLOOMINGDALE

State

Zip

60108

County

DUPAGE

Ever Disciplined

LastModifiedDate

05/02/2008