ELLIOTT M SHAPIRO OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047047420

License Status

NOT RENEWED

Business

First Name

ELLIOTT

Middle

Last Name

SHAPIRO

Suffix

Business Name

ELLIOTT M SHAPIRO OD

Original Issue Date

05/13/1993

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

CHICAGO

State

Zip

60603

County

COOK

Ever Disciplined

LastModifiedDate

09/11/2005