QUENTIN GIN PARK OD - Optometrist License in Illinois | # 047933731

QUENTIN GIN PARK OD

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047933731

License Status

CANCELLED

Business

N

First Name

QUENTIN

Middle

GIN

Last Name

PARK

Suffix

OD

Business Name

QUENTIN GIN PARK OD

Original Issue Date

01/26/2008

Effective Date

01/26/2008

Expiration Date

03/31/2010

State

IL

Ever Disciplined

N

LastModifiedDate

05/04/2010