T DANE SHELLEY OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047206644

License Status

NOT RENEWED

Business

First Name

Middle

DANE

Last Name

SHELLEY

Suffix

Business Name

T DANE SHELLEY OD

Original Issue Date

07/17/1980

Expiration Date

05/01/1982

City

OAK BROOK

State

Zip

60521

County

DUPAGE

Ever Disciplined

LastModifiedDate

09/01/2005