ELISE MARIE CORGIAT OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047935406

License Status

CANCELLED

Business

First Name

ELISE

Middle

MARIE

Last Name

CORGIAT

Suffix

Business Name

ELISE MARIE CORGIAT OD

Original Issue Date

06/10/2009

Effective Date

06/10/2009

Expiration Date

03/31/2010

City

GLEN ELLYN

State

Zip

60137

County

DUPAGE

Ever Disciplined

LastModifiedDate

05/04/2010