GEORGE MICHAEL NISTA OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047935342

License Status

CANCELLED

Business

First Name

GEORGE

Middle

MICHAEL

Last Name

NISTA

Suffix

Business Name

GEORGE MICHAEL NISTA OD

Original Issue Date

05/14/2009

Effective Date

05/14/2009

Expiration Date

03/31/2010

City

BERWYN

State

Zip

60402

County

COOK

Ever Disciplined

LastModifiedDate

05/04/2010