JENNIFER LYNN SHANE OD - Optometrist License in Illinois | # 047927555

JENNIFER LYNN SHANE OD

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047927555

License Status

NOT RENEWED

Business

N

First Name

JENNIFER

Middle

LYNN

Last Name

SHANE

Suffix

OD

Business Name

JENNIFER LYNN SHANE OD

Original Issue Date

10/30/2000

Effective Date

04/15/2002

Expiration Date

03/31/2002

State

IL

Ever Disciplined

N

LastModifiedDate

09/11/2005