LAURA A GIANCOLA Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****43

License Status

NOT RENEWED

Business

First Name

LAURA A

Last Name

GIANCOLA

Business Name

LAURA A GIANCOLA

Original Issue Date

08/01/2002

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

DOWNERS GROVE

State

Zip

60515

County

DUPAGE

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/04/2010