QUENTIN GIN PARK OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047933474

License Status

NOT RENEWED

Business

First Name

QUENTIN

Middle

GIN

Last Name

PARK

Suffix

Business Name

QUENTIN GIN PARK OD

Original Issue Date

10/16/2007

Effective Date

10/16/2007

Expiration Date

03/31/2008

City

NORTHLAKE

State

Zip

60164

County

COOK

Ever Disciplined

LastModifiedDate

05/02/2008