GREGORY D JACKSON OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047933862

License Status

CANCELLED

Business

First Name

GREGORY

Middle

Last Name

JACKSON

Suffix

Business Name

GREGORY D JACKSON OD

Original Issue Date

03/17/2008

Effective Date

03/17/2008

Expiration Date

03/31/2010

City

OSWEGO

State

Zip

60543

County

KENDALL

Ever Disciplined

LastModifiedDate

05/04/2010