T DANE SHELLEY OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST

License Number

046006644

License Status

NOT RENEWED

Business

First Name

Middle

DANE

Last Name

SHELLEY

Suffix

Business Name

T DANE SHELLEY OD

Original Issue Date

08/14/1974

Effective Date

03/05/2020

Expiration Date

05/31/2022

City

PEKIN

State

Zip

61554

County

TAZEWELL

Ever Disciplined

LastModifiedDate

07/27/2022