QUENTIN GIN PARK OD Optometrist License verification

Business Entity

ACTIVE

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****98

License Status

ACTIVE

Business

First Name

QUENTIN

Middle

GIN

Last Name

PARK

Suffix

Business Name

QUENTIN GIN PARK OD

Original Issue Date

06/28/2004

Effective Date

03/17/2026

Expiration Date

03/31/2028

City

ADDISON

State

Zip

60101

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/17/2026