GREGORY D JACKSON OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047933330

License Status

CANCELLED

Business

First Name

GREGORY

Middle

Last Name

JACKSON

Suffix

Business Name

GREGORY D JACKSON OD

Original Issue Date

08/23/2007

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

NORTH RIVERSIDE

State

Zip

60546

County

COOK

Ever Disciplined

LastModifiedDate

05/04/2010