INGER L GIBSON OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****07

License Status

CANCELLED

Business

First Name

INGER L

Last Name

GIBSON

Suffix

Business Name

INGER L GIBSON OD

Original Issue Date

06/14/1996

Effective Date

02/19/2004

Expiration Date

03/31/2006

City

LAKE GENEVA

State

Zip

53147

County

WISCONSIN

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/18/2006