LAURA A GIANCOLA Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****80

License Status

NOT RENEWED

Business

First Name

LAURA A

Last Name

GIANCOLA

Business Name

LAURA A GIANCOLA

Original Issue Date

07/03/1996

Effective Date

05/18/2000

Expiration Date

03/31/2000

City

DOWNERS GROVE

State

Zip

60515

County

DUPAGE

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/18/2006