SHAIROZ A FAZAL OD - Optometrist License in Illinois | # 047008685

SHAIROZ A FAZAL OD

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047008685

License Status

NOT RENEWED

Business

N

First Name

SHAIROZ

Middle

A

Last Name

FAZAL

Suffix

OD

Business Name

SHAIROZ A FAZAL OD

Original Issue Date

07/18/1994

Effective Date

05/15/2002

Expiration Date

03/31/2004

State

IL

Ever Disciplined

N

LastModifiedDate

09/11/2005