CAROLYN C GIBSON OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****95

License Status

NOT RENEWED

Business

Title

First Name

CAROLYN

Middle

Last Name

GIBSON

Business Name

CAROLYN C GIBSON OD

Original Issue Date

12/14/2000

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

SPARTA

State

Zip

62286

County

RANDOLPH

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/18/2006