KENNETH A SHAE Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047005058

License Status

NOT RENEWED

Business

First Name

KENNETH A

Last Name

SHAE

Business Name

KENNETH A SHAE

Original Issue Date

07/29/1988

Expiration Date

03/31/1996

City

SPRINGFIELD

State

Zip

62707

County

SANGAMON

Ever Disciplined

LastModifiedDate

09/01/2005