KENNETH R SHEPARD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047106697

License Status

NOT RENEWED

Business

First Name

KENNETH R

Last Name

SHEPARD

Business Name

KENNETH R SHEPARD

Original Issue Date

09/02/1982

Expiration Date

03/31/1986

City

CHICAGO

State

Zip

60009

County

COOK

Ever Disciplined

LastModifiedDate

09/01/2005