GREGORY D ACTIPES OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047935173

License Status

CANCELLED

Business

First Name

GREGORY

Middle

Last Name

ACTIPES

Suffix

Business Name

GREGORY D ACTIPES OD

Original Issue Date

03/20/2009

Effective Date

03/20/2009

Expiration Date

03/31/2010

City

PERU

State

Zip

61354

County

LA SALLE

Ever Disciplined

LastModifiedDate

05/04/2010