SHAWN P MALLADY OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047208619

License Status

NOT RENEWED

Business

First Name

SHAWN P

Last Name

MALLADY

Suffix

Business Name

SHAWN P MALLADY OD

Original Issue Date

07/14/1995

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

WATSEKA

State

Zip

60970

County

IROQUOIS

Ever Disciplined

LastModifiedDate

09/11/2005