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1093060097
JAISON PANICKER
OSWEGO, IL
NPI
1093060097
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
152W00000X Optometrist
(Licence: IL 046.010581)
Enumeration Date
2012-07-17
Last Update Date
2018-03-14
Business Address
JAISON PANICKER O.D.
2300 US HIGHWAY 34
OSWEGO, IL 60543-7132
Phone number: 630-554-5927
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Mailing Address
JAISON PANICKER O.D.
2300 US HIGHWAY 34
OSWEGO, IL 60543-7132
Phone number:
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